| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,324 |
3,697 |
$175K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,993 |
3,872 |
$112K |
| 92015 |
Determination of refractive state |
5,883 |
5,206 |
$78K |
| V2025 |
Deluxe frame |
1,992 |
1,934 |
$59K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,291 |
1,219 |
$57K |
| V2020 |
Frames, purchases |
750 |
739 |
$25K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
442 |
357 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,354 |
1,322 |
$17K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
299 |
294 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,316 |
1,298 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
228 |
226 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
234 |
229 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
174 |
172 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
153 |
151 |
$2K |