| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
779 |
756 |
$44K |
| V2020 |
Frames, purchases |
1,654 |
1,570 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
516 |
509 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,528 |
1,435 |
$8K |
| 92015 |
Determination of refractive state |
1,686 |
1,646 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,248 |
1,132 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$322.52 |
| 92342 |
|
378 |
371 |
$275.16 |
| 92341 |
|
12 |
12 |
$43.36 |
| 2022F |
|
200 |
199 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
26 |
26 |
$0.00 |
| V2025 |
Deluxe frame |
31 |
31 |
$0.00 |
| V2756 |
Eye glass case |
360 |
355 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
95 |
90 |
$0.00 |
| 3072F |
|
114 |
114 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
132 |
65 |
$0.00 |