| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,431 |
7,292 |
$525K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
285 |
283 |
$189K |
| 92250 |
|
4,135 |
4,070 |
$179K |
| V2500 |
Contact lens, pmma, spherical, per lens |
240 |
240 |
$166K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
291 |
291 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
714 |
357 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
92 |
91 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
296 |
148 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
86 |
81 |
$3K |
| V2020 |
Frames, purchases |
225 |
225 |
$2K |
| 92060 |
|
55 |
55 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,164 |
1,082 |
$130.00 |