| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
252 |
219 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
539 |
473 |
$16K |
| 92015 |
Determination of refractive state |
1,014 |
911 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
160 |
146 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
321 |
288 |
$7K |
| V2020 |
Frames, purchases |
89 |
85 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$409.29 |