| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,402 |
1,329 |
$152K |
| 92250 |
|
1,920 |
1,838 |
$114K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
480 |
464 |
$46K |
| 92015 |
Determination of refractive state |
2,416 |
1,864 |
$28K |
| 92083 |
|
509 |
478 |
$24K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
333 |
327 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
334 |
327 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
656 |
635 |
$13K |
| V2020 |
Frames, purchases |
685 |
664 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
605 |
584 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
602 |
582 |
$5K |
| 92081 |
|
79 |
78 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
42 |
42 |
$840.00 |
| 92082 |
|
14 |
14 |
$527.85 |
| 3072F |
|
217 |
215 |
$0.00 |