| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,840 |
3,699 |
$173K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,713 |
3,597 |
$106K |
| 92015 |
Determination of refractive state |
6,293 |
6,051 |
$104K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,797 |
1,699 |
$77K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
667 |
372 |
$30K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
657 |
623 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
797 |
770 |
$24K |
| V2020 |
Frames, purchases |
667 |
645 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
377 |
375 |
$5K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
105 |
59 |
$5K |