| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,086 |
5,070 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,855 |
2,840 |
$33K |
| V2020 |
Frames, purchases |
6,308 |
6,209 |
$24K |
| 92250 |
|
750 |
739 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,873 |
4,842 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,394 |
3,741 |
$11K |
| 92015 |
Determination of refractive state |
5,076 |
5,043 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
278 |
187 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
798 |
418 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
58 |
58 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
29 |
15 |
$0.00 |
| V2781 |
Progressive lens, per lens |
29 |
15 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
101 |
52 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
68 |
68 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
16 |
16 |
$0.00 |