| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,410 |
1,276 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
655 |
618 |
$47K |
| 92015 |
Determination of refractive state |
2,322 |
2,127 |
$46K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,300 |
1,243 |
$38K |
| 92250 |
|
2,079 |
1,888 |
$34K |
| V2020 |
Frames, purchases |
1,347 |
1,292 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
755 |
735 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,468 |
1,413 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
220 |
212 |
$3K |
| 92341 |
|
24 |
24 |
$842.50 |
| V2025 |
Deluxe frame |
38 |
38 |
$380.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
13 |
$245.00 |
| 99072 |
|
76 |
68 |
$0.00 |
| V2756 |
Eye glass case |
18 |
18 |
$0.00 |