| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,057 |
3,823 |
$185K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,853 |
4,635 |
$132K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,707 |
2,535 |
$119K |
| 92015 |
Determination of refractive state |
6,982 |
6,643 |
$115K |
| 92341 |
|
1,893 |
1,773 |
$52K |
| V2020 |
Frames, purchases |
1,709 |
1,568 |
$50K |
| V2025 |
Deluxe frame |
960 |
840 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
445 |
370 |
$17K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
348 |
343 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
270 |
232 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
193 |
181 |
$9K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
180 |
179 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
569 |
564 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
804 |
731 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
289 |
259 |
$3K |
| 92310 |
|
30 |
29 |
$2K |
| 92315 |
|
13 |
13 |
$0.00 |
| 3072F |
|
27 |
25 |
$0.00 |