| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,212 |
1,951 |
$167K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,780 |
2,929 |
$158K |
| 92015 |
Determination of refractive state |
6,987 |
5,848 |
$147K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,407 |
1,250 |
$130K |
| V2020 |
Frames, purchases |
5,197 |
4,236 |
$129K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,619 |
4,687 |
$97K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,242 |
1,875 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,056 |
889 |
$24K |
| 92002 |
|
350 |
334 |
$20K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
107 |
92 |
$4K |
| 92341 |
|
250 |
189 |
$3K |
| 92133 |
|
90 |
85 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
16 |
$430.32 |
| 92250 |
|
16 |
12 |
$387.74 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
25 |
25 |
$254.60 |
| 76514 |
|
14 |
14 |
$111.06 |
| 3072F |
|
19 |
19 |
$10.00 |