| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,784 |
2,757 |
$19K |
| V2020 |
Frames, purchases |
5,745 |
5,677 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,505 |
2,482 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,625 |
1,343 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,274 |
3,264 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,405 |
1,780 |
$6K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
202 |
202 |
$4K |
| 92225 |
|
202 |
143 |
$3K |
| 92015 |
Determination of refractive state |
3,049 |
2,996 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
831 |
658 |
$2K |
| 92250 |
|
97 |
88 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
926 |
691 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
36 |
18 |
$0.00 |
| S0500 |
Disposable contact lens, per lens |
80 |
76 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
87 |
87 |
$0.00 |
| V2756 |
Eye glass case |
22 |
22 |
$0.00 |
| V2599 |
Contact lens, other type |
250 |
250 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
63 |
58 |
$0.00 |
| 92285 |
|
20 |
20 |
$0.00 |
| 92002 |
|
13 |
13 |
$0.00 |
| 2023F |
|
17 |
13 |
$0.00 |
| 92283 |
|
12 |
12 |
$0.00 |