| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,351 |
1,351 |
$169K |
| 92250 |
|
1,899 |
1,899 |
$63K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
334 |
334 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
755 |
755 |
$23K |
| 92015 |
Determination of refractive state |
1,145 |
1,144 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
269 |
249 |
$19K |
| V2020 |
Frames, purchases |
889 |
888 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
273 |
273 |
$6K |
| 92083 |
|
13 |
12 |
$702.52 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
733 |
733 |
$0.00 |