| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
566 |
566 |
$31K |
| 92250 |
|
549 |
549 |
$21K |
| 92015 |
Determination of refractive state |
1,725 |
1,725 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
177 |
177 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
231 |
231 |
$5K |
| V2020 |
Frames, purchases |
292 |
290 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
193 |
193 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
51 |
$3K |
| 92225 |
|
60 |
60 |
$1K |
| 92002 |
|
27 |
27 |
$551.00 |