| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,439 |
3,428 |
$244K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,822 |
2,812 |
$165K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,245 |
5,151 |
$91K |
| 92015 |
Determination of refractive state |
6,302 |
6,279 |
$58K |
| V2020 |
Frames, purchases |
159 |
159 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$973.75 |