| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
722 |
645 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
612 |
514 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
354 |
325 |
$10K |
| 92015 |
Determination of refractive state |
2,205 |
1,911 |
$10K |
| 92002 |
|
229 |
205 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,424 |
1,347 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
468 |
166 |
$5K |
| V2020 |
Frames, purchases |
269 |
199 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
103 |
39 |
$783.19 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22 |
13 |
$262.02 |