| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,021 |
2,984 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,092 |
1,078 |
$8K |
| V2020 |
Frames, purchases |
1,938 |
1,903 |
$1K |
| 92015 |
Determination of refractive state |
401 |
396 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,156 |
1,605 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
30 |
28 |
$807.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,009 |
1,026 |
$608.00 |
| V2750 |
Anti-reflective coating, per lens |
853 |
426 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
269 |
135 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
58 |
29 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
128 |
62 |
$0.00 |
| 2023F |
|
46 |
46 |
$0.00 |