| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
843 |
833 |
$46K |
| V2020 |
Frames, purchases |
1,792 |
1,782 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,261 |
1,217 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
237 |
234 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
845 |
753 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
63 |
60 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
142 |
71 |
$3K |
| 92002 |
|
49 |
49 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
53 |
52 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
36 |
36 |
$1K |
| 92250 |
|
26 |
26 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$210.00 |
| 92015 |
Determination of refractive state |
112 |
104 |
$0.00 |