| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,391 |
4,363 |
$194K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,324 |
3,126 |
$85K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,407 |
1,402 |
$74K |
| V2020 |
Frames, purchases |
5,154 |
5,107 |
$65K |
| 92250 |
|
1,149 |
1,143 |
$51K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,279 |
1,228 |
$49K |
| 92015 |
Determination of refractive state |
1,407 |
1,401 |
$27K |
| 92060 |
|
640 |
632 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,137 |
1,134 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,052 |
610 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
491 |
266 |
$10K |
| 92310 |
|
27 |
27 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
156 |
94 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,021 |
1,574 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
71 |
71 |
$2K |
| 92341 |
|
64 |
63 |
$1K |
| 92082 |
|
29 |
28 |
$1K |
| 92002 |
|
25 |
25 |
$910.36 |
| 92083 |
|
12 |
12 |
$632.13 |
| V2755 |
U-v lens, per lens |
354 |
176 |
$0.00 |