| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,704 |
1,411 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
762 |
641 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
659 |
527 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
487 |
423 |
$6K |
| 92015 |
Determination of refractive state |
493 |
419 |
$32.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
83 |
81 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$0.00 |
| V2020 |
Frames, purchases |
81 |
79 |
$0.00 |