| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,362 |
3,439 |
$314K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,378 |
1,918 |
$212K |
| 92015 |
Determination of refractive state |
7,909 |
6,393 |
$149K |
| V2020 |
Frames, purchases |
5,649 |
4,992 |
$141K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,703 |
5,421 |
$115K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,264 |
2,894 |
$113K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,193 |
1,013 |
$54K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,237 |
1,947 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
853 |
717 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
51 |
51 |
$2K |
| 92341 |
|
89 |
83 |
$2K |
| 92250 |
|
58 |
58 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
126 |
125 |
$810.54 |
| 92133 |
|
39 |
36 |
$656.38 |
| 92083 |
|
13 |
12 |
$438.30 |
| 1036F |
|
65 |
61 |
$245.19 |
| 2033F |
|
97 |
86 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
15 |
14 |
$0.00 |
| 2026F |
|
769 |
646 |
$0.00 |
| 2022F |
|
60 |
46 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
13 |
12 |
$0.00 |