| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
558 |
544 |
$65K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
490 |
471 |
$41K |
| 92015 |
Determination of refractive state |
1,250 |
1,225 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
772 |
759 |
$17K |
| V2020 |
Frames, purchases |
483 |
476 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
156 |
146 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
166 |
135 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$228.00 |
| 92133 |
|
13 |
12 |
$185.96 |