| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
710 |
701 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,608 |
1,596 |
$32K |
| 92015 |
Determination of refractive state |
1,434 |
1,421 |
$15K |
| V2020 |
Frames, purchases |
1,021 |
1,014 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
215 |
214 |
$10K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
192 |
191 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
121 |
119 |
$8K |
| 92341 |
|
157 |
156 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
111 |
111 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
568 |
566 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
297 |
204 |
$452.51 |