| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
756 |
642 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,469 |
1,466 |
$78.00 |
| 92015 |
Determination of refractive state |
888 |
886 |
$0.00 |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
50 |
50 |
$0.00 |
| V2020 |
Frames, purchases |
2,742 |
2,717 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
578 |
578 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
46 |
46 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
24 |
12 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,360 |
678 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,752 |
1,752 |
$0.00 |
| V2599 |
Contact lens, other type |
99 |
99 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,527 |
1,759 |
$0.00 |
| S0592 |
Comprehensive contact lens evaluation |
28 |
28 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
206 |
103 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
87 |
87 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
36 |
18 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
30 |
15 |
$0.00 |