| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,365 |
4,176 |
$522K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,118 |
4,878 |
$496K |
| V2020 |
Frames, purchases |
7,077 |
6,987 |
$361K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,237 |
3,546 |
$242K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,675 |
3,479 |
$229K |
| 92250 |
|
3,791 |
3,549 |
$129K |
| 92015 |
Determination of refractive state |
7,024 |
6,568 |
$100K |
| 68761 |
|
1,098 |
325 |
$64K |
| V2760 |
Scratch resistant coating, per lens |
3,019 |
2,991 |
$64K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,067 |
887 |
$49K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
573 |
387 |
$32K |
| 92133 |
|
889 |
844 |
$24K |
| 92083 |
|
294 |
282 |
$13K |
| 92285 |
|
355 |
343 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
188 |
187 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
934 |
916 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
35 |
26 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$743.63 |
| 99406 |
|
82 |
65 |
$494.33 |
| 92341 |
|
12 |
12 |
$50.00 |