| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,222 |
1,216 |
$26.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
1,685 |
1,066 |
$0.00 |
| V2020 |
Frames, purchases |
22,888 |
22,729 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14,199 |
14,072 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,466 |
2,475 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
4,595 |
2,323 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25,643 |
14,404 |
$0.00 |
| S0500 |
Disposable contact lens, per lens |
1,636 |
1,630 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
4,565 |
2,329 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,978 |
2,139 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,211 |
2,216 |
$0.00 |
| 92310 |
|
1,594 |
1,574 |
$0.00 |
| 92002 |
|
6,936 |
6,928 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
87 |
66 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
310 |
153 |
$0.00 |
| V2781 |
Progressive lens, per lens |
139 |
77 |
$0.00 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
37 |
26 |
$0.00 |
| S0581 |
Nonstandard lens (list this code in addition to the basic code for the lens) |
123 |
62 |
$0.00 |