| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,778 |
4,994 |
$255K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,694 |
4,201 |
$215K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,229 |
5,510 |
$185K |
| 92015 |
Determination of refractive state |
8,780 |
7,910 |
$152K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,060 |
1,648 |
$94K |
| V2025 |
Deluxe frame |
1,875 |
1,467 |
$45K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
352 |
229 |
$41K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
861 |
720 |
$39K |
| V2020 |
Frames, purchases |
834 |
827 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
875 |
872 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
125 |
121 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
240 |
240 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
43 |
41 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
235 |
87 |
$0.00 |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
15 |
15 |
$0.00 |