| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
567 |
567 |
$70K |
| 92015 |
Determination of refractive state |
2,219 |
2,219 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
352 |
352 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
943 |
932 |
$29K |
| V2020 |
Frames, purchases |
980 |
966 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
344 |
335 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$900.00 |