| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
889 |
736 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
607 |
496 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
741 |
624 |
$13K |
| 92015 |
Determination of refractive state |
671 |
480 |
$2K |
| 92341 |
|
215 |
164 |
$1K |
| 92002 |
|
74 |
63 |
$836.70 |
| 92202 |
|
85 |
82 |
$254.44 |
| 92225 |
|
38 |
15 |
$2.04 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
74 |
28 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
25 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
185 |
137 |
$0.00 |
| V2020 |
Frames, purchases |
330 |
256 |
$0.00 |