| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,881 |
3,776 |
$298K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,697 |
1,661 |
$165K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,642 |
4,461 |
$154K |
| V2020 |
Frames, purchases |
4,331 |
4,170 |
$123K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,102 |
3,949 |
$96K |
| 92015 |
Determination of refractive state |
7,243 |
7,055 |
$87K |
| 92250 |
|
2,641 |
2,590 |
$66K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
908 |
869 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
635 |
614 |
$19K |
| 92341 |
|
156 |
148 |
$4K |
| G9905 |
Patient not screened for tobacco use |
13 |
13 |
$0.00 |