| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
940 |
753 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
484 |
378 |
$33K |
| V2020 |
Frames, purchases |
1,376 |
1,071 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
157 |
126 |
$3K |
| 3072F |
|
120 |
97 |
$3K |
| 92015 |
Determination of refractive state |
1,668 |
1,317 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
710 |
551 |
$256.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
266 |
209 |
$183.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
752 |
605 |
$100.00 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
222 |
187 |
$0.00 |