| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76512 |
|
6,534 |
3,920 |
$436K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,489 |
5,466 |
$394K |
| 92250 |
|
6,221 |
6,207 |
$279K |
| 68761 |
|
3,292 |
1,798 |
$241K |
| 92083 |
|
4,935 |
4,913 |
$232K |
| 92060 |
|
4,778 |
4,760 |
$170K |
| 92285 |
|
6,029 |
6,017 |
$154K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,329 |
3,511 |
$115K |
| V2020 |
Frames, purchases |
5,467 |
5,432 |
$98K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,029 |
1,028 |
$58K |
| 92286 |
|
490 |
490 |
$42K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,060 |
559 |
$22K |
| 92015 |
Determination of refractive state |
988 |
988 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
309 |
303 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
514 |
514 |
$7K |
| 92025 |
|
338 |
337 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
313 |
291 |
$3K |
| 76514 |
|
230 |
230 |
$2K |
| 92133 |
|
52 |
52 |
$1K |
| 92020 |
|
105 |
100 |
$1K |
| 92134 |
|
12 |
12 |
$360.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
984 |
488 |
$0.00 |