| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14,020 |
12,950 |
$617K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
17,742 |
16,244 |
$505K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,738 |
7,912 |
$371K |
| 92015 |
Determination of refractive state |
22,840 |
21,182 |
$329K |
| V2025 |
Deluxe frame |
9,701 |
9,028 |
$315K |
| V2020 |
Frames, purchases |
8,356 |
7,808 |
$145K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,809 |
6,207 |
$88K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,201 |
6,495 |
$62K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,659 |
4,428 |
$56K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,954 |
2,650 |
$36K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
517 |
510 |
$23K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,069 |
995 |
$19K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
327 |
324 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
225 |
221 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
409 |
390 |
$8K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
568 |
526 |
$8K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
544 |
500 |
$7K |
| 92341 |
|
84 |
84 |
$2K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
26 |
25 |
$306.35 |