| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,486 |
7,459 |
$247K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,544 |
4,520 |
$137K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,741 |
7,673 |
$134K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,652 |
3,269 |
$127K |
| 92250 |
|
2,629 |
2,597 |
$83K |
| 92015 |
Determination of refractive state |
11,432 |
11,372 |
$32K |
| 92083 |
|
857 |
847 |
$13K |
| 92133 |
|
649 |
639 |
$13K |
| 92020 |
|
397 |
393 |
$5K |
| V2020 |
Frames, purchases |
3,134 |
3,063 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,051 |
2,635 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,605 |
1,331 |
$616.74 |
| 76514 |
|
65 |
64 |
$516.46 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
22 |
13 |
$104.00 |
| V2750 |
Anti-reflective coating, per lens |
1,444 |
722 |
$0.00 |
| 2022F |
|
157 |
148 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
13 |
13 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
24 |
12 |
$0.00 |
| 3072F |
|
142 |
124 |
$0.00 |
| 2023F |
|
1,047 |
1,036 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
82 |
40 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
25 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$0.00 |