| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,197 |
2,048 |
$125K |
| V2020 |
Frames, purchases |
1,759 |
1,559 |
$64K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,448 |
1,103 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
229 |
206 |
$17K |
| 92015 |
Determination of refractive state |
3,245 |
2,991 |
$16K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
803 |
600 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
66 |
64 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
25 |
22 |
$489.08 |
| 92250 |
|
17 |
16 |
$360.00 |