| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,149 |
5,125 |
$284K |
| 92250 |
|
3,172 |
3,158 |
$140K |
| 92002 |
|
3,364 |
3,363 |
$100K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,886 |
4,231 |
$93K |
| V2020 |
Frames, purchases |
8,175 |
8,152 |
$72K |
| 92285 |
|
2,673 |
2,531 |
$70K |
| 76512 |
|
1,003 |
730 |
$68K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,437 |
4,431 |
$65K |
| 92082 |
|
1,438 |
1,428 |
$60K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,992 |
4,397 |
$42K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,141 |
960 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
620 |
620 |
$18K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
508 |
385 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
157 |
157 |
$9K |
| 92341 |
|
310 |
310 |
$6K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
63 |
63 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
74 |
74 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
84 |
59 |
$1K |
| 92134 |
|
529 |
523 |
$324.20 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$233.56 |
| 92025 |
|
13 |
13 |
$63.94 |
| 92015 |
Determination of refractive state |
37 |
37 |
$19.00 |