| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,621 |
6,541 |
$399K |
| 92250 |
|
5,664 |
5,605 |
$251K |
| 76512 |
|
1,877 |
1,189 |
$133K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,630 |
4,243 |
$119K |
| 92285 |
|
4,301 |
4,159 |
$98K |
| V2020 |
Frames, purchases |
7,962 |
7,898 |
$82K |
| 92082 |
|
1,757 |
1,753 |
$76K |
| 92083 |
|
1,354 |
1,337 |
$65K |
| 92286 |
|
778 |
750 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
965 |
962 |
$54K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,641 |
947 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,770 |
1,764 |
$22K |
| 92025 |
|
844 |
819 |
$18K |
| 68761 |
|
202 |
181 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,736 |
1,330 |
$12K |
| 92002 |
|
360 |
355 |
$8K |
| 92020 |
|
229 |
226 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,750 |
2,528 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
92 |
92 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
137 |
136 |
$2K |
| 92225 |
|
52 |
52 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
128 |
79 |
$1K |
| 92341 |
|
57 |
57 |
$954.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
26 |
24 |
$942.00 |
| 92133 |
|
93 |
93 |
$514.51 |
| 92134 |
|
224 |
222 |
$272.24 |
| 92015 |
Determination of refractive state |
65 |
64 |
$237.50 |
| V2755 |
U-v lens, per lens |
3,464 |
1,724 |
$0.00 |