| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,056 |
1,055 |
$58K |
| 92002 |
|
695 |
695 |
$38K |
| V2020 |
Frames, purchases |
7,075 |
6,994 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,245 |
4,619 |
$21K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,565 |
1,127 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,509 |
3,028 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
718 |
718 |
$13K |
| 92015 |
Determination of refractive state |
2,233 |
2,233 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,664 |
4,647 |
$4K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
47 |
47 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
455 |
455 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
428 |
228 |
$0.00 |
| V2599 |
Contact lens, other type |
104 |
104 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
82 |
82 |
$0.00 |
| 3072F |
|
22 |
22 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
732 |
730 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
81 |
81 |
$0.00 |