| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,175 |
2,169 |
$151K |
| 92250 |
|
1,505 |
1,504 |
$71K |
| 92285 |
|
1,440 |
1,439 |
$31K |
| 92060 |
|
659 |
659 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
331 |
329 |
$14K |
| 68761 |
|
171 |
85 |
$13K |
| 92015 |
Determination of refractive state |
886 |
886 |
$9K |
| V2020 |
Frames, purchases |
889 |
889 |
$7K |
| 92202 |
|
207 |
207 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
314 |
226 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
170 |
118 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
178 |
177 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
105 |
105 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
57 |
40 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
18 |
$718.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
14 |
$672.06 |
| 92002 |
|
15 |
15 |
$585.00 |
| V2755 |
U-v lens, per lens |
208 |
104 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
122 |
61 |
$0.00 |