| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,518 |
1,163 |
$107K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
855 |
640 |
$61K |
| V2020 |
Frames, purchases |
2,517 |
1,794 |
$57K |
| 92015 |
Determination of refractive state |
2,536 |
1,875 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
888 |
731 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,699 |
1,243 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,631 |
1,179 |
$5K |
| 3072F |
|
1,097 |
925 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
337 |
235 |
$590.03 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
945 |
696 |
$0.00 |