| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
853 |
714 |
$84K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
600 |
593 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
415 |
414 |
$44K |
| 92250 |
|
1,498 |
1,356 |
$35K |
| 92015 |
Determination of refractive state |
2,205 |
2,035 |
$30K |
| V2025 |
Deluxe frame |
247 |
246 |
$13K |
| 92370 |
|
579 |
571 |
$13K |
| V2020 |
Frames, purchases |
351 |
347 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
314 |
313 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
80 |
79 |
$1K |
| 92060 |
|
27 |
27 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
13 |
$890.48 |