| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,382 |
7,360 |
$433K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,789 |
4,017 |
$296K |
| 68761 |
|
3,600 |
1,980 |
$163K |
| 76512 |
|
3,036 |
1,379 |
$105K |
| 92250 |
|
2,578 |
2,371 |
$72K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,566 |
1,286 |
$61K |
| 92285 |
|
2,999 |
2,354 |
$32K |
| 92083 |
|
1,076 |
1,000 |
$27K |
| 92225 |
|
1,124 |
560 |
$26K |
| 92015 |
Determination of refractive state |
3,339 |
3,181 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
711 |
688 |
$13K |
| 92133 |
|
771 |
696 |
$13K |
| 92134 |
|
638 |
527 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82 |
82 |
$3K |
| 92201 |
|
325 |
208 |
$2K |
| V2020 |
Frames, purchases |
2,403 |
2,358 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,923 |
1,483 |
$1K |
| 92136 |
|
73 |
24 |
$773.42 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,526 |
1,317 |
$691.60 |
| 92226 |
|
29 |
15 |
$651.33 |
| 92202 |
|
98 |
54 |
$479.86 |
| 92286 |
|
41 |
36 |
$401.65 |
| 67820 |
|
14 |
13 |
$290.18 |
| 92020 |
|
15 |
15 |
$167.08 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
295 |
224 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
64 |
31 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
1,253 |
627 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
1,807 |
925 |
$0.00 |