| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,955 |
2,946 |
$101K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,430 |
2,782 |
$69K |
| V2020 |
Frames, purchases |
5,193 |
5,056 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,414 |
1,409 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
988 |
983 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
724 |
354 |
$13K |
| 92015 |
Determination of refractive state |
911 |
911 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,508 |
1,047 |
$10K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
218 |
217 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
91 |
78 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,468 |
1,692 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
27 |
$366.64 |
| V2755 |
U-v lens, per lens |
1,038 |
514 |
$0.00 |