| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,822 |
7,389 |
$354K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,111 |
7,716 |
$349K |
| 92015 |
Determination of refractive state |
16,427 |
15,833 |
$266K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
389 |
389 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
512 |
506 |
$14K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
294 |
294 |
$14K |
| 92341 |
|
31 |
31 |
$907.68 |
| V2020 |
Frames, purchases |
137 |
133 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
78 |
76 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
116 |
114 |
$0.00 |