| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
749 |
743 |
$31K |
| 92015 |
Determination of refractive state |
1,336 |
1,318 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
424 |
423 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
566 |
561 |
$15K |
| V2025 |
Deluxe frame |
330 |
325 |
$12K |
| V2020 |
Frames, purchases |
280 |
271 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
403 |
400 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
248 |
245 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
34 |
34 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
14 |
14 |
$650.30 |