| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92286 |
|
347 |
347 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
676 |
676 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
947 |
947 |
$13K |
| V2020 |
Frames, purchases |
2,367 |
2,341 |
$11K |
| V2199 |
Not otherwise classified, single vision lens |
1,750 |
874 |
$9K |
| 92285 |
|
453 |
453 |
$9K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
450 |
445 |
$8K |
| 92025 |
|
148 |
148 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
578 |
538 |
$5K |
| V2299 |
Specialty bifocal (by report) |
382 |
191 |
$3K |
| 92002 |
|
75 |
75 |
$3K |
| 92341 |
|
92 |
92 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
135 |
108 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
20 |
20 |
$189.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
905 |
452 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,161 |
582 |
$0.00 |