| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
774 |
772 |
$28K |
| V2020 |
Frames, purchases |
8,249 |
8,146 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,800 |
2,986 |
$4K |
| 92015 |
Determination of refractive state |
1,203 |
1,198 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,457 |
1,297 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,969 |
3,066 |
$2K |
| 92250 |
|
67 |
66 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
31 |
$945.20 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,387 |
1,234 |
$602.80 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$286.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$160.00 |
| V2599 |
Contact lens, other type |
142 |
142 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
74 |
37 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
354 |
176 |
$0.00 |
| V2781 |
Progressive lens, per lens |
74 |
37 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,050 |
521 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
217 |
217 |
$0.00 |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
358 |
358 |
$0.00 |
| V2501 |
Contact lens, pmma, toric or prism ballast, per lens |
13 |
13 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
54 |
26 |
$0.00 |