| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,616 |
2,609 |
$192K |
| 92083 |
|
1,519 |
1,513 |
$75K |
| 92250 |
|
1,495 |
1,487 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,671 |
2,149 |
$61K |
| V2020 |
Frames, purchases |
5,188 |
5,149 |
$55K |
| 92285 |
|
1,781 |
1,770 |
$45K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
582 |
351 |
$18K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
162 |
162 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
702 |
702 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
845 |
577 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
70 |
70 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,776 |
969 |
$2K |
| 92015 |
Determination of refractive state |
86 |
86 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
83 |
83 |
$900.00 |
| 92341 |
|
12 |
12 |
$216.00 |
| V2755 |
U-v lens, per lens |
122 |
61 |
$0.00 |