| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,721 |
4,170 |
$212K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,705 |
4,244 |
$138K |
| 92015 |
Determination of refractive state |
6,962 |
6,340 |
$118K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,665 |
2,408 |
$117K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
878 |
607 |
$50K |
| V2025 |
Deluxe frame |
1,655 |
1,365 |
$46K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
494 |
386 |
$22K |
| V2020 |
Frames, purchases |
540 |
540 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,278 |
1,209 |
$12K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
715 |
649 |
$9K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
115 |
114 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
78 |
77 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
128 |
127 |
$1K |
| 92341 |
|
84 |
84 |
$1K |