| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
348 |
316 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
763 |
698 |
$12K |
| 92015 |
Determination of refractive state |
710 |
644 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
56 |
55 |
$3K |
| V2020 |
Frames, purchases |
14 |
13 |
$425.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$104.18 |