| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
633 |
563 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
535 |
409 |
$24K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
163 |
109 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
285 |
242 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
422 |
403 |
$12K |
| 92015 |
Determination of refractive state |
590 |
567 |
$10K |
| V2020 |
Frames, purchases |
294 |
273 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
111 |
111 |
$5K |
| V2025 |
Deluxe frame |
407 |
266 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
71 |
71 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$630.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
123 |
123 |
$385.00 |
| V2781 |
Progressive lens, per lens |
13 |
13 |
$0.00 |