| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
967 |
871 |
$44K |
| 92015 |
Determination of refractive state |
1,472 |
1,319 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
512 |
443 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
615 |
549 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
243 |
215 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
27 |
$1K |
| V2020 |
Frames, purchases |
12 |
12 |
$129.60 |