| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,944 |
3,728 |
$173K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,698 |
4,458 |
$137K |
| 92015 |
Determination of refractive state |
6,515 |
6,212 |
$116K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,872 |
1,752 |
$86K |
| V2025 |
Deluxe frame |
1,821 |
1,701 |
$53K |
| V2020 |
Frames, purchases |
2,064 |
1,936 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,057 |
1,914 |
$24K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
441 |
438 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,564 |
2,382 |
$19K |
| 92341 |
|
496 |
475 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
596 |
556 |
$9K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
192 |
190 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
100 |
100 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
381 |
346 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$194.58 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$123.50 |
| 99072 |
|
456 |
405 |
$0.00 |