| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
179 |
167 |
$8K |
| 92015 |
Determination of refractive state |
268 |
244 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
31 |
26 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
76 |
70 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45 |
40 |
$537.27 |
| V2020 |
Frames, purchases |
36 |
31 |
$527.00 |