| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12,940 |
11,364 |
$546K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15,021 |
13,677 |
$429K |
| 92015 |
Determination of refractive state |
19,301 |
17,723 |
$317K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,461 |
5,669 |
$278K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
11,238 |
9,865 |
$159K |
| V2020 |
Frames, purchases |
12,989 |
11,827 |
$150K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,565 |
1,376 |
$61K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,983 |
2,566 |
$58K |
| 92002 |
|
1,555 |
1,427 |
$43K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
754 |
744 |
$33K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,268 |
3,932 |
$26K |
| V2523 |
Contact lens, hydrophilic, extended wear, per lens |
256 |
239 |
$22K |
| V2025 |
Deluxe frame |
1,823 |
1,349 |
$20K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
433 |
431 |
$20K |
| V2599 |
Contact lens, other type |
186 |
175 |
$15K |
| 92310 |
|
292 |
277 |
$7K |
| 92341 |
|
166 |
166 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
170 |
168 |
$548.68 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
13 |
13 |
$146.74 |
| 3072F |
|
991 |
991 |
$0.00 |