| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,417 |
4,151 |
$257K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,447 |
1,349 |
$116K |
| V2750 |
Anti-reflective coating, per lens |
1,261 |
1,213 |
$108K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,716 |
4,555 |
$81K |
| V2020 |
Frames, purchases |
4,936 |
4,765 |
$64K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,807 |
4,096 |
$56K |
| 92015 |
Determination of refractive state |
5,373 |
5,180 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,960 |
3,656 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
941 |
918 |
$14K |
| 92250 |
|
51 |
44 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$287.20 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
15 |
$197.80 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$129.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
26 |
13 |
$0.26 |
| V2760 |
Scratch resistant coating, per lens |
68 |
66 |
$0.00 |