| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,056 |
1,011 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
207 |
194 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
832 |
806 |
$14K |
| 92015 |
Determination of refractive state |
1,774 |
1,690 |
$13K |
| V2020 |
Frames, purchases |
74 |
74 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
71 |
60 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
111 |
109 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
48 |
48 |
$2K |