| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
280 |
273 |
$13K |
| V2020 |
Frames, purchases |
398 |
375 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
112 |
108 |
$5K |
| 92015 |
Determination of refractive state |
451 |
437 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
370 |
347 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
366 |
343 |
$3K |
| G8785 |
Blood pressure reading not documented, reason not given |
12 |
12 |
$0.00 |