| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,254 |
1,141 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,016 |
980 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,538 |
1,453 |
$40K |
| 92015 |
Determination of refractive state |
2,266 |
2,088 |
$33K |
| V2020 |
Frames, purchases |
790 |
754 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
833 |
793 |
$10K |
| V2025 |
Deluxe frame |
347 |
318 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
158 |
151 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
508 |
486 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
104 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
14 |
14 |
$510.95 |