| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,119 |
1,106 |
$54K |
| 92285 |
|
865 |
860 |
$43K |
| V2020 |
Frames, purchases |
1,613 |
1,589 |
$30K |
| 92250 |
|
636 |
631 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
404 |
397 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
150 |
150 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
141 |
131 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
177 |
176 |
$4K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
336 |
324 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
347 |
335 |
$2K |
| 92083 |
|
29 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
145 |
142 |
$890.00 |
| 92133 |
|
15 |
15 |
$408.66 |
| V2219 |
Bifocal seg width over 28 mm |
29 |
26 |
$285.00 |
| 92341 |
|
13 |
13 |
$100.00 |
| 92015 |
Determination of refractive state |
177 |
176 |
$0.00 |