| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
373 |
373 |
$35K |
| 92250 |
|
407 |
407 |
$19K |
| 68761 |
|
138 |
97 |
$15K |
| V2020 |
Frames, purchases |
974 |
965 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
670 |
552 |
$14K |
| 92083 |
|
189 |
184 |
$9K |
| 92285 |
|
273 |
272 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
43 |
43 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
229 |
228 |
$3K |
| 92015 |
Determination of refractive state |
252 |
250 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
167 |
166 |
$3K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
79 |
79 |
$2K |
| V2202 |
Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens |
29 |
28 |
$1K |
| 92341 |
|
29 |
29 |
$526.68 |