| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,364 |
4,089 |
$143K |
| 92083 |
|
2,414 |
1,985 |
$111K |
| 92250 |
|
2,609 |
2,224 |
$87K |
| V2020 |
Frames, purchases |
1,200 |
1,062 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,770 |
787 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
969 |
899 |
$39K |
| 92284 |
|
445 |
330 |
$14K |
| 92134 |
|
385 |
314 |
$11K |
| S0500 |
Disposable contact lens, per lens |
71 |
53 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,610 |
686 |
$5K |
| 92275 |
|
107 |
107 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
278 |
192 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
151 |
75 |
$3K |
| 92273 |
|
753 |
747 |
$2K |
| 92283 |
|
136 |
114 |
$1K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
21 |
19 |
$630.00 |
| 2026F |
|
50 |
50 |
$0.00 |
| 2025F |
|
28 |
28 |
$0.00 |
| 2024F |
|
36 |
36 |
$0.00 |
| S0592 |
Comprehensive contact lens evaluation |
13 |
12 |
$0.00 |