| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
644 |
615 |
$31K |
| V2020 |
Frames, purchases |
321 |
285 |
$19K |
| 92015 |
Determination of refractive state |
2,190 |
1,796 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
146 |
136 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
207 |
186 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
70 |
63 |
$3K |
| V2756 |
Eye glass case |
705 |
644 |
$991.62 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
47 |
37 |
$882.12 |
| 92250 |
|
13 |
13 |
$671.19 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$460.07 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
196 |
183 |
$427.61 |
| V2750 |
Anti-reflective coating, per lens |
104 |
95 |
$263.36 |
| V2025 |
Deluxe frame |
273 |
272 |
$0.00 |