| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
781 |
771 |
$78K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
621 |
614 |
$74K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
485 |
473 |
$35K |
| V2020 |
Frames, purchases |
1,548 |
1,513 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
817 |
801 |
$16K |
| 92015 |
Determination of refractive state |
1,914 |
1,885 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
504 |
486 |
$10K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
224 |
224 |
$9K |
| 92083 |
|
83 |
82 |
$4K |
| 92060 |
|
59 |
59 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
78 |
77 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
34 |
34 |
$1K |
| 92250 |
|
12 |
12 |
$776.25 |
| 92133 |
|
14 |
14 |
$469.86 |