| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
581 |
557 |
$31K |
| 92015 |
Determination of refractive state |
1,486 |
1,323 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
139 |
137 |
$9K |
| V2020 |
Frames, purchases |
118 |
109 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
67 |
56 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
81 |
81 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$255.60 |