| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
645 |
617 |
$57K |
| 92015 |
Determination of refractive state |
832 |
780 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
239 |
231 |
$24K |
| V2020 |
Frames, purchases |
528 |
515 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
846 |
793 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
325 |
317 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
117 |
96 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
15 |
$555.60 |