| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,125 |
2,999 |
$126K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,655 |
2,564 |
$108K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,237 |
4,110 |
$85K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,574 |
4,364 |
$85K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,590 |
5,308 |
$77K |
| V2020 |
Frames, purchases |
5,862 |
5,578 |
$75K |
| 92015 |
Determination of refractive state |
4,364 |
4,214 |
$56K |
| V2750 |
Anti-reflective coating, per lens |
2,109 |
2,029 |
$44K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
833 |
814 |
$22K |
| 92341 |
|
758 |
741 |
$15K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
109 |
109 |
$5K |
| S0500 |
Disposable contact lens, per lens |
17 |
16 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
16 |
$720.00 |
| 3072F |
|
231 |
230 |
$170.00 |
| 2026F |
|
538 |
535 |
$0.00 |