| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
740 |
737 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,292 |
1,261 |
$25K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
352 |
348 |
$16K |
| 92015 |
Determination of refractive state |
1,200 |
1,190 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
183 |
183 |
$12K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
229 |
222 |
$10K |
| V2020 |
Frames, purchases |
332 |
327 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
166 |
166 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
248 |
246 |
$1K |
| 92341 |
|
29 |
29 |
$666.42 |
| 92250 |
|
13 |
13 |
$256.74 |
| 99072 |
|
514 |
484 |
$2.45 |