| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
910 |
814 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
985 |
924 |
$31K |
| V2020 |
Frames, purchases |
1,200 |
1,097 |
$15K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
252 |
247 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
859 |
762 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
246 |
236 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
468 |
417 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
35 |
34 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
46 |
45 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$330.00 |
| 92015 |
Determination of refractive state |
1,234 |
1,118 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |