| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,176 |
8,156 |
$368.41 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,497 |
4,491 |
$52.00 |
| 92015 |
Determination of refractive state |
8,364 |
8,308 |
$4.40 |
| V2299 |
Specialty bifocal (by report) |
368 |
184 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,355 |
3,621 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,567 |
1,205 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
11,169 |
7,256 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,977 |
6,256 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
1,149 |
644 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
112 |
112 |
$0.00 |
| V2781 |
Progressive lens, per lens |
647 |
367 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
17 |
12 |
$0.00 |
| V2020 |
Frames, purchases |
13,724 |
13,509 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
241 |
241 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
6,776 |
3,923 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,062 |
778 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
18 |
12 |
$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 |
21 |
12 |
$0.00 |