| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
502 |
497 |
$35K |
| 92083 |
|
531 |
531 |
$28K |
| 92250 |
|
547 |
547 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
201 |
200 |
$8K |
| 92015 |
Determination of refractive state |
439 |
439 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
238 |
119 |
$5K |
| 92133 |
|
107 |
107 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
194 |
194 |
$3K |
| V2020 |
Frames, purchases |
212 |
212 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
14 |
$893.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
13 |
$0.00 |