| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12,748 |
12,267 |
$1.04M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,308 |
8,044 |
$862K |
| 92015 |
Determination of refractive state |
20,685 |
19,968 |
$235K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,551 |
4,523 |
$121K |
| V2025 |
Deluxe frame |
2,684 |
2,668 |
$100K |
| V2020 |
Frames, purchases |
4,704 |
4,628 |
$88K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,923 |
1,734 |
$86K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,115 |
4,770 |
$84K |
| 92250 |
|
652 |
616 |
$23K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,272 |
1,223 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,215 |
1,163 |
$18K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
274 |
266 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
28 |
26 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
27 |
27 |
$1K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
67 |
66 |
$863.76 |
| 3072F |
|
15,879 |
15,497 |
$33.45 |
| 2023F |
|
19 |
19 |
$0.00 |
| 1036F |
|
34 |
33 |
$0.00 |