| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,180 |
1,180 |
$129K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
614 |
614 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,021 |
2,018 |
$61K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
685 |
683 |
$54K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,907 |
1,905 |
$53K |
| 92060 |
|
767 |
763 |
$42K |
| 92015 |
Determination of refractive state |
2,320 |
2,316 |
$41K |
| 92002 |
|
329 |
329 |
$25K |
| 92285 |
|
1,272 |
1,254 |
$24K |
| V2020 |
Frames, purchases |
2,016 |
2,012 |
$20K |
| 92083 |
|
313 |
310 |
$16K |
| 92250 |
|
465 |
465 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
127 |
127 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
34 |
34 |
$948.60 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
14 |
$418.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
429 |
428 |
$0.00 |