| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,534 |
1,409 |
$119K |
| V2020 |
Frames, purchases |
2,428 |
2,186 |
$63K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,260 |
1,192 |
$48K |
| 92015 |
Determination of refractive state |
1,643 |
1,477 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
311 |
275 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
671 |
521 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
753 |
595 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,819 |
1,670 |
$12K |
| 92250 |
|
173 |
141 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
441 |
413 |
$4K |
| 92083 |
|
74 |
57 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
15 |
$595.70 |
| 92133 |
|
38 |
27 |
$461.28 |
| 92134 |
|
13 |
12 |
$227.64 |
| V2702 |
Deluxe lens feature |
36 |
36 |
$17.10 |
| 2026F |
|
35 |
35 |
$0.00 |
| 3072F |
|
214 |
204 |
$0.00 |