| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,181 |
4,963 |
$235K |
| 92015 |
Determination of refractive state |
8,602 |
8,177 |
$147K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,070 |
4,827 |
$147K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,314 |
2,136 |
$101K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,279 |
721 |
$56K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
732 |
701 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
905 |
883 |
$29K |
| V2020 |
Frames, purchases |
794 |
779 |
$20K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
240 |
145 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
375 |
375 |
$5K |