| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,920 |
4,418 |
$234K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,590 |
4,076 |
$128K |
| 92015 |
Determination of refractive state |
7,106 |
6,459 |
$116K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,545 |
2,360 |
$112K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,169 |
1,765 |
$64K |
| V2025 |
Deluxe frame |
1,716 |
1,258 |
$59K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
844 |
762 |
$38K |
| V2020 |
Frames, purchases |
1,268 |
1,181 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,002 |
960 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
94 |
94 |
$4K |
| 92341 |
|
142 |
122 |
$4K |
| 92310 |
|
39 |
39 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
21 |
17 |
$722.25 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
16 |
16 |
$711.20 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
441 |
433 |
$220.52 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
80 |
79 |
$0.00 |