| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,648 |
4,391 |
$270K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,359 |
2,244 |
$170K |
| V2020 |
Frames, purchases |
9,476 |
8,745 |
$133K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,452 |
5,994 |
$104K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,470 |
8,741 |
$79K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
8,337 |
7,657 |
$43K |
| 92015 |
Determination of refractive state |
6,232 |
5,835 |
$20K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
4,940 |
4,554 |
$18K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,339 |
1,243 |
$17K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
237 |
236 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
676 |
641 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
482 |
430 |
$7K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
45 |
45 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
33 |
31 |
$317.50 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$172.50 |