| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,917 |
2,217 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,868 |
1,526 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,995 |
2,506 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
916 |
785 |
$10K |
| V2020 |
Frames, purchases |
378 |
370 |
$9K |
| 68761 |
|
3,218 |
1,394 |
$806.68 |
| 92341 |
|
92 |
90 |
$282.65 |
| 92226 |
|
499 |
458 |
$156.77 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
30 |
28 |
$150.00 |
| 92202 |
|
563 |
464 |
$53.06 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
39 |
$47.66 |
| V2780 |
Oversize lens, per lens |
215 |
213 |
$34.00 |
| 92225 |
|
18 |
18 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
15 |
$0.00 |