| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,304 |
1,255 |
$85K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,381 |
1,351 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
521 |
504 |
$54K |
| 92250 |
|
1,034 |
992 |
$44K |
| 92083 |
|
729 |
703 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
750 |
732 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
201 |
170 |
$10K |
| V2020 |
Frames, purchases |
309 |
300 |
$5K |
| V2025 |
Deluxe frame |
144 |
137 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
229 |
227 |
$3K |
| 92202 |
|
141 |
136 |
$953.92 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
18 |
18 |
$811.47 |
| 92133 |
|
13 |
12 |
$301.72 |