| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,334 |
4,309 |
$184K |
| V2020 |
Frames, purchases |
4,466 |
4,345 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,032 |
1,488 |
$39K |
| 92060 |
|
946 |
937 |
$32K |
| 92250 |
|
848 |
848 |
$28K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,448 |
910 |
$24K |
| 92285 |
|
836 |
835 |
$22K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
163 |
80 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
110 |
53 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
55 |
55 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,753 |
1,920 |
$1K |
| 92083 |
|
14 |
14 |
$644.50 |
| 92015 |
Determination of refractive state |
148 |
143 |
$0.00 |