| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,755 |
7,245 |
$227K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,293 |
3,997 |
$200K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,949 |
3,721 |
$175K |
| 92015 |
Determination of refractive state |
8,222 |
7,731 |
$144K |
| V2025 |
Deluxe frame |
5,104 |
4,721 |
$126K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,428 |
1,308 |
$65K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,317 |
3,092 |
$42K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
617 |
524 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,281 |
3,077 |
$21K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
375 |
374 |
$17K |
| V2020 |
Frames, purchases |
1,005 |
938 |
$13K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
264 |
264 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
277 |
251 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
37 |
26 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
244 |
238 |
$3K |
| 2022F |
|
26 |
25 |
$0.00 |