| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,209 |
3,209 |
$335K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,827 |
1,827 |
$227K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,731 |
3,719 |
$113K |
| 92015 |
Determination of refractive state |
4,477 |
4,474 |
$79K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,007 |
902 |
$66K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,815 |
1,814 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,666 |
1,662 |
$42K |
| V2020 |
Frames, purchases |
3,970 |
3,964 |
$40K |
| 92250 |
|
163 |
163 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
16 |
16 |
$446.40 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$251.10 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,197 |
2,191 |
$0.00 |