| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,450 |
2,445 |
$180K |
| 92250 |
|
1,675 |
1,672 |
$74K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,015 |
2,008 |
$61K |
| V2020 |
Frames, purchases |
4,533 |
4,449 |
$46K |
| 92285 |
|
1,446 |
1,445 |
$40K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
622 |
621 |
$35K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,077 |
569 |
$24K |
| 92083 |
|
184 |
181 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
742 |
374 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
228 |
226 |
$9K |
| 92133 |
|
71 |
71 |
$2K |
| V2219 |
Bifocal seg width over 28 mm |
12 |
12 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
53 |
52 |
$585.00 |
| 76514 |
|
25 |
25 |
$183.77 |
| 92341 |
|
12 |
12 |
$180.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,292 |
1,131 |
$100.00 |