| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,534 |
2,494 |
$112K |
| 92015 |
Determination of refractive state |
3,957 |
3,914 |
$60K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,397 |
1,396 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,898 |
1,867 |
$56K |
| V2020 |
Frames, purchases |
1,521 |
1,460 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
592 |
519 |
$27K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
559 |
456 |
$25K |
| V2025 |
Deluxe frame |
844 |
820 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,829 |
1,789 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,020 |
1,016 |
$12K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
109 |
109 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
20 |
20 |
$929.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
16 |
16 |
$711.20 |