| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,122 |
4,039 |
$201K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,671 |
2,618 |
$158K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,494 |
2,206 |
$88K |
| V2020 |
Frames, purchases |
4,931 |
4,801 |
$56K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,328 |
1,170 |
$48K |
| 92341 |
|
1,575 |
1,481 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,756 |
1,706 |
$26K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
830 |
404 |
$24K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
399 |
198 |
$11K |
| 92015 |
Determination of refractive state |
860 |
860 |
$8K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
38 |
38 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
32 |
32 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,440 |
4,627 |
$406.08 |
| 92370 |
|
40 |
39 |
$273.00 |
| 3072F |
|
50 |
50 |
$0.00 |