| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,379 |
1,363 |
$115K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
566 |
559 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,828 |
1,773 |
$38K |
| 92015 |
Determination of refractive state |
2,223 |
2,182 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
778 |
740 |
$14K |
| 92310 |
|
89 |
89 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
272 |
215 |
$4K |
| V2025 |
Deluxe frame |
12 |
12 |
$819.00 |
| 92082 |
|
26 |
24 |
$754.00 |
| 92250 |
|
17 |
17 |
$490.87 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
33 |
27 |
$194.25 |