| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
430 |
373 |
$18K |
| 92015 |
Determination of refractive state |
578 |
484 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
663 |
513 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
489 |
374 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
105 |
100 |
$6K |
| V2020 |
Frames, purchases |
611 |
497 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
169 |
163 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
306 |
251 |
$2K |
| 92250 |
|
80 |
72 |
$481.03 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
198 |
191 |
$384.00 |