| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,048 |
1,010 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
787 |
745 |
$36K |
| 92015 |
Determination of refractive state |
1,555 |
1,547 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
297 |
215 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
467 |
467 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
298 |
237 |
$13K |
| V2020 |
Frames, purchases |
318 |
318 |
$11K |
| V2025 |
Deluxe frame |
385 |
286 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
261 |
261 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
60 |
$657.14 |
| 3072F |
|
592 |
592 |
$0.00 |