| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,968 |
2,587 |
$165K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,309 |
1,149 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,703 |
3,234 |
$57K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,962 |
3,459 |
$49K |
| V2020 |
Frames, purchases |
3,831 |
3,343 |
$43K |
| 92015 |
Determination of refractive state |
4,297 |
3,768 |
$33K |
| V2499 |
Variable sphericity lens, other type |
455 |
442 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,360 |
2,066 |
$21K |
| 68761 |
|
650 |
226 |
$6K |
| 92250 |
|
160 |
144 |
$5K |
| V2750 |
Anti-reflective coating, per lens |
24 |
23 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
151 |
113 |
$1K |
| V2755 |
U-v lens, per lens |
177 |
172 |
$686.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
12 |
12 |
$311.00 |
| A4262 |
Temporary, absorbable lacrimal duct implant, each |
18 |
18 |
$0.00 |