| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
252 |
248 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
191 |
187 |
$4K |
| 92015 |
Determination of refractive state |
326 |
322 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
98 |
98 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
98 |
96 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$585.00 |
| V2020 |
Frames, purchases |
76 |
74 |
$342.00 |