| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,239 |
1,207 |
$83K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
945 |
901 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
184 |
179 |
$17K |
| 92015 |
Determination of refractive state |
1,797 |
1,724 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
503 |
473 |
$9K |
| V2020 |
Frames, purchases |
872 |
757 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
488 |
435 |
$9K |
| V2760 |
Scratch resistant coating, per lens |
220 |
211 |
$3K |
| 92250 |
|
13 |
13 |
$635.58 |
| 1036F |
|
84 |
84 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
37 |
37 |
$0.00 |