| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,220 |
3,199 |
$140K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
953 |
947 |
$88K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,371 |
1,262 |
$83K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,460 |
2,443 |
$73K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,108 |
1,097 |
$48K |
| V2025 |
Deluxe frame |
1,135 |
1,131 |
$41K |
| V2020 |
Frames, purchases |
2,231 |
2,214 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,098 |
2,024 |
$40K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,137 |
1,119 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
169 |
166 |
$20K |
| 92015 |
Determination of refractive state |
1,228 |
1,216 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
518 |
494 |
$9K |
| 92250 |
|
122 |
121 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
423 |
396 |
$7K |