| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,151 |
1,129 |
$54K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
448 |
423 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,190 |
1,156 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
295 |
288 |
$13K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
70 |
67 |
$5K |
| V2020 |
Frames, purchases |
921 |
897 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
476 |
465 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
519 |
507 |
$100.00 |