| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,390 |
1,390 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,248 |
1,246 |
$20K |
| 92250 |
|
610 |
608 |
$15K |
| 92225 |
|
457 |
366 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
587 |
587 |
$11K |
| V2020 |
Frames, purchases |
2,677 |
2,655 |
$5K |
| 92015 |
Determination of refractive state |
1,210 |
1,206 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,943 |
1,901 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
251 |
248 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
900 |
876 |
$611.80 |
| 92226 |
|
16 |
12 |
$277.06 |
| V2744 |
Tint, photochromatic, per lens |
31 |
24 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
16 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
471 |
456 |
$0.00 |