| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,862 |
3,840 |
$278K |
| 92083 |
|
2,913 |
2,898 |
$146K |
| 92250 |
|
2,780 |
2,764 |
$130K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,273 |
2,954 |
$77K |
| V2020 |
Frames, purchases |
7,329 |
7,234 |
$76K |
| 92285 |
|
2,596 |
2,585 |
$68K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
498 |
494 |
$29K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
985 |
509 |
$20K |
| 92225 |
|
1,205 |
672 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
281 |
281 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,194 |
1,188 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,604 |
1,038 |
$10K |
| 92202 |
|
732 |
480 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,141 |
630 |
$5K |
| 92341 |
|
181 |
180 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
205 |
203 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
249 |
167 |
$3K |
| 92015 |
Determination of refractive state |
204 |
203 |
$2K |
| V2219 |
Bifocal seg width over 28 mm |
13 |
13 |
$748.00 |
| 92002 |
|
14 |
13 |
$589.61 |
| V2755 |
U-v lens, per lens |
78 |
38 |
$0.00 |