| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
724 |
717 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
517 |
507 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,070 |
1,049 |
$21K |
| 92015 |
Determination of refractive state |
1,708 |
1,689 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
736 |
725 |
$10K |
| V2020 |
Frames, purchases |
918 |
896 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
882 |
859 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
44 |
42 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
119 |
98 |
$1K |
| 92285 |
|
59 |
54 |
$807.12 |
| 92370 |
|
14 |
12 |
$294.98 |
| 92081 |
|
12 |
12 |
$251.33 |