| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,166 |
1,085 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
743 |
668 |
$34K |
| 92015 |
Determination of refractive state |
1,944 |
1,770 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,317 |
1,287 |
$8K |
| V2020 |
Frames, purchases |
196 |
163 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32 |
13 |
$390.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
12 |
$231.00 |