| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
514 |
511 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
502 |
494 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
872 |
872 |
$7K |
| 92015 |
Determination of refractive state |
1,366 |
1,354 |
$6K |
| V2020 |
Frames, purchases |
176 |
162 |
$3K |
| 92100 |
|
80 |
76 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20 |
12 |
$574.14 |
| 92250 |
|
42 |
40 |
$538.15 |
| V2219 |
Bifocal seg width over 28 mm |
33 |
16 |
$532.00 |
| 92225 |
|
12 |
12 |
$126.08 |