| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,920 |
1,916 |
$95K |
| V2020 |
Frames, purchases |
4,691 |
4,661 |
$87K |
| 92250 |
|
1,395 |
1,392 |
$62K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,511 |
2,251 |
$51K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,013 |
999 |
$27K |
| 92285 |
|
950 |
941 |
$27K |
| 92002 |
|
970 |
963 |
$24K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
198 |
181 |
$8K |
| 92083 |
|
145 |
144 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
684 |
355 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
70 |
70 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
997 |
522 |
$3K |
| 92202 |
|
41 |
41 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
71 |
71 |
$920.00 |
| 92132 |
|
37 |
37 |
$902.06 |
| 92341 |
|
52 |
52 |
$900.00 |
| 92020 |
|
78 |
77 |
$765.51 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
43 |
43 |
$555.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,868 |
925 |
$0.00 |