| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
951 |
940 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
384 |
378 |
$7K |
| 92015 |
Determination of refractive state |
1,194 |
1,155 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
107 |
107 |
$2K |
| V2020 |
Frames, purchases |
488 |
487 |
$123.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
170 |
111 |
$105.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
36 |
36 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
281 |
149 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
138 |
68 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
400 |
219 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
73 |
73 |
$0.00 |