| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,553 |
2,400 |
$214K |
| 92015 |
Determination of refractive state |
4,659 |
4,314 |
$95K |
| V2020 |
Frames, purchases |
2,987 |
2,708 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,154 |
2,873 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
278 |
235 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
727 |
631 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
288 |
263 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
180 |
159 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
16 |
15 |
$456.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| 92341 |
|
25 |
15 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
78 |
48 |
$0.00 |