| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,717 |
2,683 |
$84K |
| V2020 |
Frames, purchases |
3,483 |
3,373 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,460 |
1,423 |
$27K |
| 92250 |
|
587 |
577 |
$25K |
| 92083 |
|
527 |
518 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
959 |
883 |
$15K |
| 92285 |
|
369 |
364 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
464 |
427 |
$10K |
| 92002 |
|
331 |
323 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
725 |
658 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
89 |
89 |
$3K |
| 92225 |
|
75 |
44 |
$2K |
| 92015 |
Determination of refractive state |
589 |
586 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
49 |
44 |
$891.00 |
| V2750 |
Anti-reflective coating, per lens |
30 |
17 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
113 |
113 |
$0.00 |