| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,331 |
1,187 |
$55K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,015 |
914 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
714 |
527 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,128 |
1,084 |
$32K |
| 92015 |
Determination of refractive state |
1,954 |
1,819 |
$29K |
| V2020 |
Frames, purchases |
681 |
602 |
$19K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
235 |
231 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
456 |
397 |
$6K |
| V2025 |
Deluxe frame |
301 |
206 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
35 |
35 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
95 |
94 |
$854.92 |