| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,462 |
1,197 |
$108K |
| 92250 |
|
2,229 |
1,813 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,033 |
804 |
$75K |
| 92081 |
|
2,138 |
1,656 |
$35K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
762 |
563 |
$31K |
| 92015 |
Determination of refractive state |
2,815 |
2,247 |
$31K |
| 92082 |
|
733 |
685 |
$27K |
| 65778 |
|
18 |
13 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
957 |
715 |
$13K |
| V2020 |
Frames, purchases |
922 |
691 |
$8K |
| 92100 |
|
289 |
236 |
$7K |
| 99350 |
Prolong home eval add 15m |
63 |
56 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
357 |
274 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$360.00 |
| 99349 |
|
12 |
12 |
$348.28 |
| 92225 |
|
12 |
12 |
$45.48 |
| 92202 |
|
49 |
41 |
$38.34 |