| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,261 |
2,253 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,006 |
1,001 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
975 |
968 |
$12K |
| 92015 |
Determination of refractive state |
2,990 |
2,968 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,298 |
1,143 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,254 |
634 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
406 |
211 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
22 |
22 |
$0.00 |
| 3072F |
|
13 |
13 |
$0.00 |
| V2020 |
Frames, purchases |
1,928 |
1,918 |
$0.00 |