| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,950 |
1,894 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,249 |
1,198 |
$58K |
| 92015 |
Determination of refractive state |
3,099 |
2,992 |
$52K |
| V2025 |
Deluxe frame |
1,292 |
1,224 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,177 |
1,107 |
$33K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
582 |
580 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
394 |
391 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
823 |
758 |
$15K |
| V2020 |
Frames, purchases |
519 |
511 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
809 |
724 |
$7K |
| 92250 |
|
69 |
67 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
41 |
37 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
18 |
18 |
$836.10 |
| 92133 |
|
13 |
13 |
$305.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$135.54 |