| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15,650 |
14,084 |
$706K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16,388 |
14,416 |
$471K |
| 92015 |
Determination of refractive state |
23,353 |
21,039 |
$338K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,666 |
6,799 |
$333K |
| V2025 |
Deluxe frame |
8,526 |
7,925 |
$304K |
| V2020 |
Frames, purchases |
8,608 |
7,528 |
$129K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
7,882 |
6,839 |
$102K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,815 |
4,805 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,853 |
3,583 |
$46K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,402 |
2,045 |
$29K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
502 |
498 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
382 |
305 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,017 |
906 |
$17K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
316 |
314 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
327 |
313 |
$6K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
470 |
398 |
$6K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
167 |
145 |
$2K |