| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,357 |
1,327 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
611 |
601 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
824 |
806 |
$16K |
| V2020 |
Frames, purchases |
726 |
715 |
$11K |
| 92015 |
Determination of refractive state |
230 |
224 |
$4K |
| 92341 |
|
58 |
55 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$600.24 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
13 |
13 |
$323.44 |