| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
771 |
618 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
734 |
655 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,063 |
1,947 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
561 |
542 |
$4K |
| 92285 |
|
645 |
591 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
184 |
113 |
$2K |
| 92002 |
|
325 |
314 |
$2K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
76 |
68 |
$937.10 |
| 92341 |
|
45 |
31 |
$661.77 |
| 92015 |
Determination of refractive state |
32 |
31 |
$572.91 |
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
12 |
12 |
$366.79 |
| 92225 |
|
22 |
22 |
$63.24 |