| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,262 |
3,197 |
$143K |
| V2020 |
Frames, purchases |
4,895 |
4,786 |
$66K |
| 92250 |
|
1,280 |
1,249 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
927 |
891 |
$40K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,069 |
1,842 |
$37K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
527 |
498 |
$23K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
608 |
573 |
$12K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
325 |
305 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,550 |
1,143 |
$9K |
| 92083 |
|
125 |
124 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
930 |
489 |
$6K |
| 92285 |
|
105 |
104 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
120 |
114 |
$4K |
| 92202 |
|
268 |
257 |
$2K |
| 92060 |
|
80 |
64 |
$1K |
| 92225 |
|
39 |
39 |
$554.35 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
15 |
$228.64 |