| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,059 |
3,914 |
$256K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,917 |
6,591 |
$118K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,134 |
1,091 |
$97K |
| 92015 |
Determination of refractive state |
6,550 |
6,286 |
$56K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
730 |
714 |
$22K |
| V2020 |
Frames, purchases |
918 |
892 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
562 |
543 |
$11K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
139 |
137 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
907 |
879 |
$3K |
| 92250 |
|
16 |
12 |
$416.39 |