| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
266 |
247 |
$23K |
| 92015 |
Determination of refractive state |
1,085 |
964 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
120 |
116 |
$13K |
| V2020 |
Frames, purchases |
464 |
357 |
$11K |
| 92250 |
|
467 |
453 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
442 |
345 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
101 |
98 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
37 |
37 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
80 |
53 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
211 |
173 |
$798.00 |
| 2026F |
|
24 |
24 |
$0.00 |