| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
910 |
906 |
$85K |
| V2020 |
Frames, purchases |
2,689 |
2,666 |
$78K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
588 |
580 |
$30K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
285 |
279 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
975 |
870 |
$16K |
| 92250 |
|
250 |
248 |
$12K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
58 |
58 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
296 |
165 |
$3K |
| 92083 |
|
54 |
53 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
928 |
638 |
$2K |
| 92225 |
|
105 |
60 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
81 |
72 |
$1K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
23 |
23 |
$952.14 |
| V2755 |
U-v lens, per lens |
75 |
38 |
$5.00 |