| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
389 |
389 |
$23K |
| 92015 |
Determination of refractive state |
1,041 |
1,032 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
401 |
393 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
897 |
889 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
90 |
88 |
$2K |
| V2020 |
Frames, purchases |
137 |
134 |
$807.00 |