| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,634 |
2,564 |
$214K |
| 92015 |
Determination of refractive state |
4,763 |
4,656 |
$50K |
| V2020 |
Frames, purchases |
1,465 |
1,405 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
369 |
362 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
765 |
744 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
589 |
316 |
$9K |
| 92370 |
|
25 |
25 |
$556.23 |