| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,132 |
2,004 |
$34K |
| 92341 |
|
1,097 |
1,026 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,085 |
1,020 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
186 |
160 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
99 |
$6K |
| 99336 |
|
82 |
62 |
$5K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
48 |
48 |
$2K |
| V2020 |
Frames, purchases |
1,326 |
1,251 |
$2K |
| 3072F |
|
220 |
209 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
13 |
$625.00 |
| V2755 |
U-v lens, per lens |
694 |
660 |
$224.66 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
22 |
16 |
$206.72 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
128 |
126 |
$110.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
714 |
680 |
$93.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
15 |
$0.00 |
| V2025 |
Deluxe frame |
25 |
13 |
$0.00 |