| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
427 |
390 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
274 |
255 |
$12K |
| 92015 |
Determination of refractive state |
756 |
694 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
343 |
303 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
168 |
159 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$555.70 |