| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,327 |
1,324 |
$0.00 |
| 92015 |
Determination of refractive state |
143 |
143 |
$0.00 |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
26 |
26 |
$0.00 |
| V2020 |
Frames, purchases |
1,749 |
1,746 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
117 |
117 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
641 |
641 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
754 |
753 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
208 |
208 |
$0.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
477 |
475 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
72 |
72 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
14 |
14 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
16 |
16 |
$0.00 |
| V2781 |
Progressive lens, per lens |
13 |
13 |
$0.00 |