| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,185 |
1,180 |
$67K |
| V2020 |
Frames, purchases |
1,733 |
1,684 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,611 |
1,580 |
$31K |
| 92015 |
Determination of refractive state |
2,692 |
2,679 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
333 |
331 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
251 |
249 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
742 |
730 |
$12K |
| 92250 |
|
66 |
65 |
$1K |
| 92341 |
|
61 |
61 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
64 |
$714.30 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$607.75 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
15 |
$540.43 |