| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25,312 |
25,286 |
$1.87M |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,176 |
4,125 |
$164K |
| 92015 |
Determination of refractive state |
2,822 |
2,797 |
$112K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,398 |
1,397 |
$86K |
| V2020 |
Frames, purchases |
4,307 |
4,257 |
$49K |
| 92201 |
|
168 |
168 |
$3K |
| 92202 |
|
85 |
85 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
168 |
168 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
85 |
85 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
23 |
$242.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,970 |
2,475 |
$0.00 |