| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
207 |
205 |
$11K |
| 92015 |
Determination of refractive state |
746 |
724 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
105 |
105 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
69 |
67 |
$8K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
28 |
28 |
$3K |
| V2020 |
Frames, purchases |
137 |
135 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
19 |
18 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
77 |
45 |
$488.80 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
36 |
35 |
$345.68 |
| 92370 |
|
37 |
36 |
$266.60 |