| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,660 |
1,428 |
$72K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,191 |
1,013 |
$54K |
| 92015 |
Determination of refractive state |
2,990 |
2,582 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,669 |
1,348 |
$50K |
| V2020 |
Frames, purchases |
2,285 |
1,901 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,372 |
1,057 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,473 |
1,198 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
570 |
545 |
$8K |
| 92341 |
|
202 |
165 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
28 |
$329.11 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
17 |
17 |
$157.00 |