| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,483 |
2,341 |
$152K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,128 |
1,063 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,231 |
3,970 |
$69K |
| 92015 |
Determination of refractive state |
5,242 |
4,873 |
$41K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
202 |
200 |
$5K |
| V2020 |
Frames, purchases |
16 |
14 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$934.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
26 |
26 |
$910.00 |
| 92250 |
|
29 |
25 |
$900.01 |