| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,943 |
1,942 |
$206K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
991 |
991 |
$125K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,720 |
1,716 |
$52K |
| 92015 |
Determination of refractive state |
2,500 |
2,498 |
$44K |
| 92250 |
|
1,304 |
1,304 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
951 |
944 |
$26K |
| V2020 |
Frames, purchases |
1,761 |
1,760 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
158 |
158 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
218 |
218 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$334.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,783 |
1,782 |
$35.00 |