| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,047 |
1,014 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
419 |
405 |
$20K |
| V2020 |
Frames, purchases |
615 |
602 |
$20K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
269 |
268 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
150 |
148 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
84 |
84 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
346 |
338 |
$3K |
| 92015 |
Determination of refractive state |
556 |
556 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
88 |
85 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
53 |
53 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
13 |
$797.32 |
| V2025 |
Deluxe frame |
15 |
15 |
$178.20 |