| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
7,592 |
7,497 |
$343K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,424 |
4,348 |
$320K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,324 |
5,205 |
$280K |
| 92083 |
|
5,217 |
5,121 |
$245K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,448 |
2,999 |
$95K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,453 |
2,161 |
$95K |
| V2020 |
Frames, purchases |
4,321 |
4,268 |
$63K |
| 92225 |
|
2,056 |
984 |
$29K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
880 |
501 |
$23K |
| 92226 |
|
1,032 |
510 |
$14K |
| V2500 |
Contact lens, pmma, spherical, per lens |
12 |
12 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
703 |
356 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,250 |
1,731 |
$2K |
| 68761 |
|
14 |
12 |
$1K |
| 92285 |
|
12 |
12 |
$311.19 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$196.95 |
| 92020 |
|
13 |
13 |
$195.12 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
15 |
$176.32 |
| 92015 |
Determination of refractive state |
62 |
62 |
$91.20 |
| 2026F |
|
14 |
14 |
$0.00 |
| V2025 |
Deluxe frame |
13 |
13 |
$0.00 |