| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,409 |
3,244 |
$549K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,045 |
1,950 |
$333K |
| V2020 |
Frames, purchases |
4,451 |
4,245 |
$60K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
527 |
452 |
$29K |
| 92015 |
Determination of refractive state |
5,337 |
5,107 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,600 |
3,436 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,870 |
2,736 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,777 |
1,661 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
234 |
206 |
$5K |
| 92341 |
|
407 |
379 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
196 |
188 |
$800.00 |
| V2755 |
U-v lens, per lens |
87 |
85 |
$30.00 |