| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,884 |
1,715 |
$112K |
| 92015 |
Determination of refractive state |
2,342 |
2,187 |
$85K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,775 |
2,579 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
123 |
118 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
46 |
46 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
344 |
331 |
$140.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
182 |
176 |
$0.00 |
| 92250 |
|
119 |
63 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
13 |
$0.00 |
| V2020 |
Frames, purchases |
335 |
322 |
$0.00 |
| 2024F |
|
371 |
335 |
$0.00 |
| 2026F |
|
16 |
15 |
$0.00 |