| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,403 |
1,402 |
$102K |
| 92250 |
|
1,182 |
1,182 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
590 |
590 |
$39K |
| 92015 |
Determination of refractive state |
1,809 |
1,809 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
374 |
350 |
$16K |
| 68761 |
|
55 |
55 |
$6K |
| 92083 |
|
105 |
102 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
399 |
399 |
$5K |
| V2020 |
Frames, purchases |
524 |
524 |
$4K |
| 92286 |
|
15 |
15 |
$1K |
| 92225 |
|
25 |
25 |
$1K |
| 92285 |
|
77 |
76 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
38 |
$311.85 |