| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
870 |
864 |
$61K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,263 |
1,249 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
94 |
94 |
$6K |
| 92015 |
Determination of refractive state |
539 |
538 |
$5K |
| V2020 |
Frames, purchases |
116 |
116 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
57 |
$786.77 |
| 92341 |
|
29 |
29 |
$607.38 |