| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
405 |
307 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
90 |
57 |
$2K |
| 92015 |
Determination of refractive state |
36 |
30 |
$266.37 |
| 92341 |
|
17 |
17 |
$255.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$180.00 |
| V2020 |
Frames, purchases |
210 |
183 |
$26.60 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
16 |
$0.00 |