| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,211 |
2,939 |
$279K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,129 |
1,918 |
$214K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,596 |
2,176 |
$83K |
| V2020 |
Frames, purchases |
2,231 |
1,408 |
$73K |
| 92250 |
|
1,455 |
1,284 |
$62K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,958 |
1,762 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,129 |
690 |
$45K |
| V2025 |
Deluxe frame |
541 |
320 |
$45K |
| 92015 |
Determination of refractive state |
2,322 |
2,180 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
73 |
65 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
14 |
$595.94 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
24 |
14 |
$262.56 |