| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,255 |
1,975 |
$102K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,546 |
1,307 |
$67K |
| 92015 |
Determination of refractive state |
3,529 |
3,255 |
$63K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,717 |
1,599 |
$50K |
| V2025 |
Deluxe frame |
1,139 |
956 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
543 |
424 |
$25K |
| 92250 |
|
192 |
156 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
30 |
12 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
27 |
27 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
65 |
65 |
$791.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
217 |
197 |
$759.50 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$540.00 |
| V2020 |
Frames, purchases |
65 |
64 |
$460.40 |