| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,796 |
3,694 |
$136K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,859 |
1,796 |
$30K |
| 92250 |
|
596 |
593 |
$22K |
| V2020 |
Frames, purchases |
2,295 |
2,215 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,771 |
1,597 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
739 |
713 |
$12K |
| 92015 |
Determination of refractive state |
4,321 |
4,181 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,243 |
986 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$286.00 |
| 2026F |
|
214 |
210 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
19 |
19 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
211 |
116 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
62 |
62 |
$0.00 |