| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,519 |
3,292 |
$232K |
| V2020 |
Frames, purchases |
4,060 |
3,635 |
$55K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
669 |
608 |
$51K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,136 |
2,839 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,717 |
2,187 |
$38K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
190 |
168 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
885 |
805 |
$10K |
| V2760 |
Scratch resistant coating, per lens |
512 |
443 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
138 |
126 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
316 |
246 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
48 |
39 |
$2K |
| 92250 |
|
47 |
45 |
$2K |
| 92133 |
|
13 |
13 |
$253.69 |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |