| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
947 |
870 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
839 |
828 |
$36K |
| 92015 |
Determination of refractive state |
1,915 |
1,814 |
$29K |
| V2025 |
Deluxe frame |
1,167 |
1,066 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
366 |
329 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
236 |
208 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
571 |
537 |
$16K |
| V2020 |
Frames, purchases |
710 |
688 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
302 |
271 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
635 |
619 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
106 |
101 |
$5K |
| 92341 |
|
117 |
93 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
51 |
48 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
146 |
145 |
$2K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
29 |
28 |
$364.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$234.58 |