| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
952 |
910 |
$60K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,526 |
1,436 |
$60K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,054 |
985 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
227 |
211 |
$8K |
| 92015 |
Determination of refractive state |
2,642 |
2,509 |
$5K |
| V2020 |
Frames, purchases |
1,134 |
1,063 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,609 |
1,510 |
$3K |
| 92310 |
|
19 |
17 |
$95.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
166 |
152 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
27 |
26 |
$0.00 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
492 |
473 |
$0.00 |
| V2025 |
Deluxe frame |
446 |
412 |
$0.00 |