| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13,309 |
12,411 |
$586K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,880 |
8,398 |
$412K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,755 |
11,963 |
$375K |
| 92015 |
Determination of refractive state |
21,799 |
20,720 |
$374K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
683 |
679 |
$30K |
| V2020 |
Frames, purchases |
1,187 |
1,156 |
$22K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
333 |
331 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,886 |
978 |
$15K |
| 92310 |
|
244 |
241 |
$11K |
| 92250 |
|
84 |
84 |
$3K |
| 92083 |
|
13 |
13 |
$462.98 |
| 3072F |
|
1,928 |
1,928 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
111 |
110 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
118 |
117 |
$0.00 |