| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,499 |
10,433 |
$121K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,851 |
7,817 |
$90K |
| 92015 |
Determination of refractive state |
9,377 |
9,298 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,227 |
1,201 |
$14K |
| V2020 |
Frames, purchases |
3,648 |
3,611 |
$540.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,264 |
2,621 |
$63.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,747 |
2,391 |
$34.20 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
228 |
210 |
$27.50 |
| 92083 |
|
14 |
13 |
$17.00 |
| 92201 |
|
16 |
14 |
$1.00 |
| V2750 |
Anti-reflective coating, per lens |
1,073 |
549 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
178 |
178 |
$0.00 |
| 68761 |
|
13 |
13 |
$0.00 |
| 92286 |
|
18 |
18 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
418 |
225 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
26 |
13 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
104 |
52 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
90 |
90 |
$0.00 |
| V2781 |
Progressive lens, per lens |
51 |
27 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
48 |
24 |
$0.00 |