| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
675 |
667 |
$55K |
| 92015 |
Determination of refractive state |
2,149 |
2,110 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
380 |
379 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
887 |
875 |
$17K |
| 92002 |
|
266 |
261 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
208 |
204 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
44 |
44 |
$789.60 |
| V2020 |
Frames, purchases |
15 |
12 |
$750.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
43 |
$558.90 |