| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,248 |
4,822 |
$229K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,976 |
4,692 |
$138K |
| 92015 |
Determination of refractive state |
7,659 |
7,208 |
$127K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,669 |
2,455 |
$122K |
| V2025 |
Deluxe frame |
2,948 |
2,540 |
$96K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,644 |
2,319 |
$84K |
| V2020 |
Frames, purchases |
1,322 |
1,318 |
$46K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
397 |
301 |
$36K |
| 92341 |
|
1,178 |
1,079 |
$34K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
581 |
437 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,079 |
2,026 |
$20K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
104 |
104 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
312 |
312 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$603.85 |
| 3072F |
|
12 |
12 |
$0.00 |