| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,568 |
1,218 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
978 |
696 |
$46K |
| 92015 |
Determination of refractive state |
1,706 |
1,230 |
$38K |
| V2020 |
Frames, purchases |
1,977 |
1,527 |
$33K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,612 |
1,187 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
176 |
149 |
$10K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
520 |
353 |
$6K |
| 92250 |
|
77 |
67 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
40 |
37 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
69 |
63 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$1K |
| 92341 |
|
14 |
14 |
$274.72 |