| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,858 |
2,707 |
$133K |
| 92015 |
Determination of refractive state |
5,010 |
4,712 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,707 |
1,595 |
$84K |
| V2020 |
Frames, purchases |
3,072 |
2,958 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,126 |
1,631 |
$28K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
724 |
709 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
607 |
584 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
777 |
754 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
205 |
199 |
$4K |
| 92250 |
|
84 |
72 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
37 |
$942.46 |
| 92341 |
|
43 |
43 |
$781.70 |
| 92310 |
|
15 |
15 |
$569.00 |
| V2025 |
Deluxe frame |
34 |
34 |
$561.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
12 |
$281.00 |
| 99072 |
|
124 |
120 |
$210.00 |