| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,224 |
9,159 |
$75K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,963 |
3,942 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
405 |
400 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
598 |
596 |
$9K |
| 92015 |
Determination of refractive state |
7,919 |
7,836 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17,573 |
8,699 |
$3K |
| V2020 |
Frames, purchases |
10,855 |
10,583 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16,499 |
8,121 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
1,124 |
553 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
13 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
89 |
89 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
168 |
83 |
$0.00 |
| 2022F |
|
14 |
14 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
157 |
157 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
250 |
121 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,247 |
1,172 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
266 |
144 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
52 |
26 |
$0.00 |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
12 |
12 |
$0.00 |