| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,158 |
2,116 |
$106K |
| 92015 |
Determination of refractive state |
2,589 |
2,545 |
$84K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,383 |
1,341 |
$72K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
846 |
835 |
$60K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
802 |
797 |
$34K |
| V2025 |
Deluxe frame |
470 |
470 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,225 |
1,217 |
$25K |
| V2020 |
Frames, purchases |
1,372 |
1,349 |
$24K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
269 |
268 |
$12K |
| 92250 |
|
12 |
12 |
$589.82 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
21 |
20 |
$462.00 |