| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,579 |
2,130 |
$113K |
| 92015 |
Determination of refractive state |
3,485 |
2,939 |
$63K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,852 |
1,464 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
718 |
633 |
$31K |
| V2020 |
Frames, purchases |
51 |
51 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
46 |
46 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$130.00 |