| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
754 |
726 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
488 |
470 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
722 |
696 |
$20K |
| 92015 |
Determination of refractive state |
879 |
849 |
$14K |
| V2020 |
Frames, purchases |
258 |
255 |
$8K |
| 92341 |
|
142 |
141 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
26 |
26 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
78 |
$854.92 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
51 |
43 |
$568.66 |
| V2025 |
Deluxe frame |
12 |
12 |
$120.00 |
| 3072F |
|
126 |
126 |
$0.00 |