| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,988 |
2,838 |
$227K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
908 |
866 |
$88K |
| 92015 |
Determination of refractive state |
4,680 |
4,477 |
$58K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,925 |
1,877 |
$50K |
| V2020 |
Frames, purchases |
1,755 |
1,707 |
$32K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
534 |
483 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,654 |
1,613 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,028 |
1,001 |
$17K |
| 92310 |
|
60 |
60 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
217 |
213 |
$3K |
| 92341 |
|
14 |
14 |
$424.34 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
22 |
22 |
$192.61 |
| 2023F |
|
39 |
39 |
$0.00 |
| 5010F |
|
111 |
93 |
$0.00 |