| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,082 |
1,082 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
563 |
563 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,952 |
1,945 |
$35K |
| 92015 |
Determination of refractive state |
2,239 |
2,238 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$799.00 |