| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,193 |
1,523 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
702 |
563 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
221 |
142 |
$6K |
| 92015 |
Determination of refractive state |
1,097 |
998 |
$4K |
| V2020 |
Frames, purchases |
348 |
281 |
$1K |
| 92341 |
|
98 |
93 |
$781.97 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
12 |
$180.00 |
| 92083 |
|
18 |
14 |
$120.62 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$14.00 |
| 92250 |
|
52 |
27 |
$0.00 |