| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,010 |
993 |
$119K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
602 |
592 |
$59K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
248 |
233 |
$16K |
| V2020 |
Frames, purchases |
165 |
152 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
96 |
89 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
144 |
135 |
$2K |
| 92133 |
|
64 |
64 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
145 |
136 |
$2K |
| 92083 |
|
50 |
50 |
$2K |
| 92250 |
|
25 |
25 |
$1K |
| 92015 |
Determination of refractive state |
1,582 |
1,558 |
$78.20 |