| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,686 |
1,686 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,160 |
1,160 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,886 |
1,885 |
$11K |
| 92015 |
Determination of refractive state |
2,863 |
2,863 |
$11K |
| V2020 |
Frames, purchases |
467 |
467 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
92 |
$4K |
| 92341 |
|
66 |
66 |
$566.40 |
| 92250 |
|
26 |
26 |
$173.04 |