| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,643 |
7,673 |
$371K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,743 |
5,128 |
$166K |
| 92015 |
Determination of refractive state |
10,754 |
9,681 |
$161K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,599 |
2,266 |
$108K |
| V2025 |
Deluxe frame |
3,007 |
2,722 |
$100K |
| V2020 |
Frames, purchases |
1,928 |
1,725 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,553 |
2,261 |
$32K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
574 |
499 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
910 |
705 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
612 |
560 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
437 |
373 |
$5K |
| 92285 |
|
110 |
103 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
20 |
16 |
$900.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
13 |
13 |
$533.40 |
| 92341 |
|
13 |
13 |
$376.08 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
32 |
25 |
$305.62 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$202.00 |
| 83861 |
|
14 |
12 |
$185.64 |
| 3072F |
|
16 |
15 |
$0.00 |