| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,844 |
1,807 |
$171K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,530 |
1,468 |
$163K |
| V2020 |
Frames, purchases |
6,174 |
6,036 |
$89K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,278 |
4,188 |
$74K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,575 |
1,564 |
$67K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,013 |
985 |
$57K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,948 |
1,880 |
$37K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
532 |
528 |
$22K |
| 92015 |
Determination of refractive state |
3,680 |
3,591 |
$20K |
| V2025 |
Deluxe frame |
179 |
176 |
$8K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
193 |
183 |
$3K |
| 92060 |
|
15 |
15 |
$667.95 |