| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
990 |
978 |
$67K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
873 |
865 |
$56K |
| 92015 |
Determination of refractive state |
1,775 |
1,751 |
$29K |
| 92310 |
|
423 |
422 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,052 |
1,038 |
$17K |
| V2020 |
Frames, purchases |
14 |
14 |
$300.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$100.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$83.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$78.00 |