| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2110 |
Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens |
32,214 |
16,211 |
$720K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,235 |
7,058 |
$706K |
| 92250 |
|
8,779 |
8,519 |
$499K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32,063 |
16,092 |
$358K |
| V2020 |
Frames, purchases |
17,405 |
16,943 |
$304K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,692 |
1,667 |
$202K |
| 92273 |
|
3,003 |
1,509 |
$141K |
| 92015 |
Determination of refractive state |
8,050 |
7,781 |
$124K |
| 92100 |
|
2,539 |
2,482 |
$105K |
| 95930 |
|
4,057 |
2,332 |
$102K |
| 92083 |
|
2,901 |
2,839 |
$102K |
| V2760 |
Scratch resistant coating, per lens |
8,831 |
4,363 |
$85K |
| V2750 |
Anti-reflective coating, per lens |
8,828 |
4,362 |
$85K |
| 92025 |
|
2,942 |
2,872 |
$80K |
| 92020 |
|
2,559 |
2,504 |
$34K |
| 65778 |
|
188 |
185 |
$26K |
| 76514 |
|
1,166 |
993 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
515 |
494 |
$10K |
| 92275 |
|
360 |
334 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
129 |
117 |
$6K |
| 92285 |
|
200 |
198 |
$3K |
| 92310 |
|
41 |
40 |
$1K |
| 83861 |
|
66 |
33 |
$1K |
| 92274 |
|
413 |
412 |
$1K |
| 92132 |
|
57 |
53 |
$173.14 |
| 92283 |
|
70 |
62 |
$0.00 |