| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,341 |
3,200 |
$270K |
| 92250 |
|
5,273 |
5,097 |
$216K |
| V2020 |
Frames, purchases |
7,123 |
6,904 |
$201K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,801 |
1,730 |
$177K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,561 |
5,347 |
$114K |
| 92015 |
Determination of refractive state |
4,240 |
4,085 |
$45K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
498 |
496 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
730 |
713 |
$15K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
265 |
256 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
434 |
431 |
$8K |
| V2750 |
Anti-reflective coating, per lens |
338 |
338 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
119 |
119 |
$3K |