| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,978 |
1,936 |
$126K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
951 |
909 |
$54K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,679 |
979 |
$42K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,395 |
680 |
$32K |
| V2020 |
Frames, purchases |
3,396 |
2,674 |
$28K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
642 |
641 |
$24K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
490 |
486 |
$15K |
| 92341 |
|
588 |
582 |
$11K |
| V2220 |
Bifocal add over 3.25d |
446 |
444 |
$7K |
| 92002 |
|
89 |
89 |
$1K |
| 92201 |
|
12 |
12 |
$228.76 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$180.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
34 |
18 |
$160.32 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,528 |
902 |
$120.00 |
| V2755 |
U-v lens, per lens |
158 |
79 |
$0.00 |