| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,900 |
2,336 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,007 |
2,595 |
$84K |
| V2020 |
Frames, purchases |
6,534 |
5,629 |
$71K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,430 |
3,827 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,075 |
1,026 |
$29K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
570 |
558 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,790 |
2,388 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
633 |
538 |
$14K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
273 |
253 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
365 |
334 |
$8K |
| V2299 |
Specialty bifocal (by report) |
39 |
39 |
$640.90 |
| V2781 |
Progressive lens, per lens |
25 |
25 |
$165.00 |
| 92015 |
Determination of refractive state |
3,662 |
3,108 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
330 |
300 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
74 |
67 |
$0.00 |