| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,581 |
1,317 |
$69K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,044 |
1,705 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,187 |
962 |
$54K |
| 92015 |
Determination of refractive state |
2,869 |
2,452 |
$52K |
| V2020 |
Frames, purchases |
298 |
279 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
178 |
171 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
146 |
131 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
16 |
$720.00 |
| 92250 |
|
17 |
13 |
$719.07 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
16 |
$191.70 |
| V2025 |
Deluxe frame |
13 |
13 |
$140.40 |