| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,700 |
1,638 |
$79K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
784 |
750 |
$50K |
| 92015 |
Determination of refractive state |
2,442 |
2,310 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
658 |
632 |
$33K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
52 |
52 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
15 |
15 |
$903.45 |
| V2020 |
Frames, purchases |
13 |
13 |
$175.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$30.00 |