| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16,276 |
16,223 |
$972K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
19,874 |
19,748 |
$947K |
| 92015 |
Determination of refractive state |
36,125 |
35,938 |
$734K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,807 |
5,885 |
$374K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,871 |
9,062 |
$232K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,574 |
9,684 |
$137K |
| V2020 |
Frames, purchases |
10,121 |
9,311 |
$124K |
| V2755 |
U-v lens, per lens |
2,151 |
2,091 |
$90K |
| 92310 |
|
2,714 |
2,697 |
$70K |
| 92002 |
|
1,098 |
1,094 |
$52K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
472 |
472 |
$42K |
| V2500 |
Contact lens, pmma, spherical, per lens |
2,111 |
2,103 |
$41K |
| 92370 |
|
538 |
521 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,730 |
2,706 |
$19K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
668 |
657 |
$11K |
| 92225 |
|
211 |
210 |
$9K |
| 92060 |
|
151 |
151 |
$6K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
125 |
122 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
305 |
300 |
$976.50 |
| 92226 |
|
12 |
12 |
$390.96 |
| 92134 |
|
35 |
33 |
$162.04 |
| 92133 |
|
15 |
12 |
$107.73 |
| V2750 |
Anti-reflective coating, per lens |
212 |
210 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$0.00 |
| 2023F |
|
1,159 |
1,059 |
$0.00 |