| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,413 |
2,356 |
$142K |
| V2020 |
Frames, purchases |
3,502 |
3,399 |
$108K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,083 |
1,055 |
$82K |
| 92015 |
Determination of refractive state |
3,718 |
3,600 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,813 |
2,725 |
$73K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,985 |
1,919 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,346 |
3,249 |
$21K |
| 92250 |
|
612 |
575 |
$10K |
| 92341 |
|
235 |
235 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
164 |
164 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
449 |
429 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
60 |
52 |
$2K |
| V2756 |
Eye glass case |
2,786 |
2,700 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
54 |
53 |
$725.04 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$171.57 |
| V2760 |
Scratch resistant coating, per lens |
28 |
28 |
$0.00 |