| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,589 |
2,361 |
$113K |
| 92015 |
Determination of refractive state |
3,735 |
3,494 |
$63K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,951 |
1,837 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,314 |
1,199 |
$54K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
274 |
194 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
984 |
938 |
$26K |
| V2020 |
Frames, purchases |
1,310 |
1,269 |
$21K |
| 92341 |
|
590 |
521 |
$17K |
| V2025 |
Deluxe frame |
657 |
520 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
202 |
179 |
$9K |
| V2599 |
Contact lens, other type |
51 |
40 |
$9K |
| 92310 |
|
43 |
40 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
45 |
45 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
175 |
174 |
$2K |
| 92133 |
|
25 |
25 |
$491.81 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
31 |
$308.40 |
| V2781 |
Progressive lens, per lens |
18 |
18 |
$0.00 |