| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,440 |
2,378 |
$209K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,112 |
1,085 |
$109K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,139 |
1,085 |
$69K |
| V2020 |
Frames, purchases |
1,685 |
1,603 |
$58K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,084 |
1,026 |
$42K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,774 |
1,689 |
$36K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
436 |
430 |
$19K |
| 92015 |
Determination of refractive state |
1,087 |
1,059 |
$14K |
| V2025 |
Deluxe frame |
39 |
38 |
$744.00 |