| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
547 |
542 |
$0.00 |
| S0500 |
Disposable contact lens, per lens |
923 |
921 |
$0.00 |
| 92250 |
|
2,616 |
2,552 |
$0.00 |
| 92002 |
|
4,521 |
4,501 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
10,786 |
6,188 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,737 |
1,248 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
243 |
165 |
$0.00 |
| 92310 |
|
920 |
889 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
596 |
309 |
$0.00 |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
101 |
51 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
24 |
12 |
$0.00 |
| V2781 |
Progressive lens, per lens |
30 |
15 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,693 |
5,571 |
$0.00 |
| V2020 |
Frames, purchases |
9,638 |
9,542 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
790 |
454 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
2,555 |
1,289 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
162 |
103 |
$0.00 |