| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,220 |
1,166 |
$113K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,074 |
1,047 |
$96K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
228 |
222 |
$18K |
| 92081 |
|
828 |
811 |
$18K |
| 92015 |
Determination of refractive state |
1,442 |
1,390 |
$16K |
| 92250 |
|
1,019 |
984 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
14 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16 |
16 |
$0.00 |
| V2020 |
Frames, purchases |
22 |
21 |
$0.00 |