| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,973 |
1,823 |
$120K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,583 |
1,520 |
$108K |
| V2020 |
Frames, purchases |
2,926 |
2,762 |
$93K |
| 92015 |
Determination of refractive state |
3,127 |
2,910 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,248 |
2,104 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
207 |
154 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,529 |
1,643 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
15 |
$892.90 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
144 |
128 |
$298.04 |
| 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 |
$144.04 |
| 92310 |
|
13 |
12 |
$85.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
226 |
171 |
$62.18 |
| 92341 |
|
150 |
144 |
$60.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
35 |
35 |
$0.00 |