| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,835 |
2,578 |
$254K |
| V2020 |
Frames, purchases |
3,904 |
3,660 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
720 |
675 |
$81K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,672 |
2,505 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,627 |
3,399 |
$74K |
| 92015 |
Determination of refractive state |
1,808 |
1,635 |
$25K |
| 92250 |
|
616 |
560 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
414 |
398 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
22 |
22 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
36 |
35 |
$647.90 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$558.54 |
| 92341 |
|
15 |
14 |
$432.77 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$389.82 |