| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,586 |
2,542 |
$155K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,664 |
1,641 |
$129K |
| 92015 |
Determination of refractive state |
4,481 |
4,354 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,935 |
1,927 |
$39K |
| V2020 |
Frames, purchases |
759 |
759 |
$23K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
224 |
221 |
$11K |
| 92341 |
|
293 |
291 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
817 |
490 |
$6K |
| 92250 |
|
249 |
238 |
$4K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
84 |
84 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
240 |
171 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$580.10 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
41 |
41 |
$174.00 |