| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,206 |
1,206 |
$118K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
508 |
508 |
$63K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,636 |
1,632 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,430 |
1,430 |
$43K |
| 92015 |
Determination of refractive state |
1,537 |
1,534 |
$27K |
| V2020 |
Frames, purchases |
1,580 |
1,578 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$895.93 |