| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,617 |
2,585 |
$298K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,733 |
1,720 |
$158K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,189 |
1,175 |
$28K |
| 92015 |
Determination of refractive state |
5,224 |
5,109 |
$938.64 |
| V2020 |
Frames, purchases |
1,178 |
1,168 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
921 |
535 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
12 |
$0.00 |