| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,238 |
1,234 |
$53K |
| 92002 |
|
1,201 |
1,201 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
694 |
694 |
$30K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
633 |
633 |
$27K |
| 92310 |
|
175 |
175 |
$9K |
| 92015 |
Determination of refractive state |
1,016 |
997 |
$5K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
15 |
15 |
$864.00 |