| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,730 |
2,637 |
$118K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,836 |
2,726 |
$112K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,364 |
4,254 |
$85K |
| 92015 |
Determination of refractive state |
5,328 |
5,125 |
$27K |
| 92341 |
|
668 |
645 |
$16K |
| 92250 |
|
595 |
512 |
$13K |
| V2020 |
Frames, purchases |
55 |
41 |
$460.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
38 |
24 |
$70.00 |