| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,166 |
3,135 |
$337K |
| V2020 |
Frames, purchases |
2,345 |
2,312 |
$134K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
652 |
652 |
$94K |
| 92250 |
|
2,049 |
2,044 |
$76K |
| 92025 |
|
1,937 |
1,933 |
$67K |
| 92015 |
Determination of refractive state |
2,495 |
2,494 |
$48K |
| 92285 |
|
2,200 |
2,169 |
$44K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
526 |
488 |
$32K |
| 68761 |
|
315 |
144 |
$27K |
| 68040 |
|
388 |
203 |
$19K |
| 92133 |
|
384 |
384 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
296 |
196 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
31 |
$744.00 |
| 76514 |
|
58 |
58 |
$641.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
44 |
44 |
$96.00 |