| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,890 |
3,862 |
$152K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
514 |
514 |
$152K |
| V2020 |
Frames, purchases |
5,849 |
5,743 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,666 |
2,840 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,602 |
3,600 |
$48K |
| 92002 |
|
949 |
946 |
$35K |
| 92015 |
Determination of refractive state |
1,667 |
1,667 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
237 |
237 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,938 |
1,670 |
$16K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
939 |
939 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,215 |
616 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
956 |
953 |
$9K |
| V2199 |
Not otherwise classified, single vision lens |
398 |
198 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
114 |
114 |
$5K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
60 |
60 |
$3K |
| 92341 |
|
137 |
136 |
$3K |
| V2299 |
Specialty bifocal (by report) |
58 |
29 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
43 |
$989.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
56 |
56 |
$604.80 |
| V2755 |
U-v lens, per lens |
2,571 |
1,286 |
$0.00 |