| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,147 |
2,146 |
$102K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,279 |
1,277 |
$46K |
| 92015 |
Determination of refractive state |
3,626 |
3,622 |
$28K |
| V2020 |
Frames, purchases |
1,176 |
1,175 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
322 |
322 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
573 |
572 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
58 |
58 |
$2K |