| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
999 |
896 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
122 |
119 |
$6K |
| 92015 |
Determination of refractive state |
1,262 |
1,147 |
$5K |
| 2023F |
|
337 |
325 |
$3K |
| 3072F |
|
399 |
385 |
$1K |
| V2020 |
Frames, purchases |
55 |
45 |
$552.18 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22 |
13 |
$11.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
17 |
15 |
$0.00 |