| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
661 |
589 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
598 |
517 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,455 |
1,431 |
$28K |
| V2020 |
Frames, purchases |
1,100 |
960 |
$27K |
| 92015 |
Determination of refractive state |
1,384 |
1,228 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
267 |
262 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
240 |
239 |
$11K |
| 92341 |
|
379 |
376 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
401 |
342 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
322 |
275 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
12 |
$233.68 |
| 2026F |
|
244 |
239 |
$0.00 |