| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,204 |
1,203 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
943 |
939 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,496 |
2,483 |
$42K |
| 92015 |
Determination of refractive state |
2,587 |
2,579 |
$32K |
| V2020 |
Frames, purchases |
240 |
238 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
242 |
237 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
212 |
210 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
16 |
$718.43 |