| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,941 |
2,704 |
$124K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,385 |
1,031 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
958 |
908 |
$42K |
| V2020 |
Frames, purchases |
894 |
893 |
$30K |
| 92015 |
Determination of refractive state |
1,603 |
1,600 |
$17K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
268 |
267 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
774 |
773 |
$10K |
| V2025 |
Deluxe frame |
827 |
533 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
363 |
363 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
84 |
84 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35 |
30 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
32 |
31 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
36 |
36 |
$1K |