| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,405 |
1,401 |
$95K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
889 |
883 |
$66K |
| 92015 |
Determination of refractive state |
2,292 |
2,282 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
539 |
536 |
$11K |
| V2020 |
Frames, purchases |
126 |
126 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
54 |
54 |
$1K |
| 92250 |
|
13 |
13 |
$354.25 |