| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
7,405 |
6,831 |
$303K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,505 |
4,196 |
$182K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,700 |
3,451 |
$172K |
| 92015 |
Determination of refractive state |
7,481 |
6,988 |
$133K |
| 92225 |
|
3,932 |
2,227 |
$132K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,168 |
3,044 |
$88K |
| 92134 |
|
1,611 |
1,408 |
$32K |
| 92226 |
|
289 |
171 |
$9K |
| V2020 |
Frames, purchases |
202 |
190 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
134 |
108 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
127 |
126 |
$3K |
| 92133 |
|
37 |
24 |
$811.63 |