| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
636 |
621 |
$27K |
| V2020 |
Frames, purchases |
969 |
949 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
699 |
685 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
693 |
679 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
254 |
250 |
$11K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
308 |
295 |
$11K |
| 92015 |
Determination of refractive state |
238 |
230 |
$4K |
| 92341 |
|
167 |
163 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
313 |
305 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
72 |
71 |
$3K |
| 92310 |
|
13 |
13 |
$893.86 |