| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,367 |
2,307 |
$107K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,562 |
1,520 |
$63K |
| 92015 |
Determination of refractive state |
3,622 |
3,510 |
$45K |
| V2020 |
Frames, purchases |
2,330 |
2,275 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,708 |
1,693 |
$35K |
| 92341 |
|
1,116 |
1,107 |
$29K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
423 |
422 |
$12K |
| 92083 |
|
861 |
809 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
500 |
498 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
392 |
361 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,107 |
1,066 |
$4K |
| 92134 |
|
218 |
212 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
261 |
250 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
177 |
174 |
$1K |
| 92250 |
|
111 |
110 |
$895.11 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$352.00 |
| 92133 |
|
13 |
13 |
$159.60 |
| 92132 |
|
12 |
12 |
$117.27 |
| V2210 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens |
12 |
12 |
$0.00 |