| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,719 |
2,896 |
$86K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,401 |
5,957 |
$85K |
| 92015 |
Determination of refractive state |
6,518 |
6,232 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,640 |
3,512 |
$37K |
| 92083 |
|
1,368 |
1,229 |
$19K |
| 92133 |
|
1,509 |
1,344 |
$18K |
| V2020 |
Frames, purchases |
4,131 |
3,999 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,230 |
2,911 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,125 |
1,654 |
$7K |
| 92134 |
|
594 |
439 |
$5K |
| 92002 |
|
94 |
87 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
642 |
356 |
$936.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$40.00 |
| V2760 |
Scratch resistant coating, per lens |
350 |
172 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
872 |
431 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
127 |
61 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
106 |
53 |
$0.00 |