| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92083 |
|
5,180 |
5,151 |
$251K |
| 92250 |
|
5,395 |
5,370 |
$247K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,722 |
3,707 |
$222K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,994 |
3,854 |
$164K |
| 92133 |
|
3,028 |
3,024 |
$91K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,178 |
1,178 |
$90K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,969 |
2,223 |
$70K |
| V2020 |
Frames, purchases |
2,550 |
2,543 |
$34K |
| 68761 |
|
433 |
224 |
$27K |
| 92015 |
Determination of refractive state |
1,049 |
1,023 |
$17K |
| 76512 |
|
203 |
154 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
417 |
417 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
274 |
272 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
63 |
$3K |
| 92020 |
|
145 |
144 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
174 |
89 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
43 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
909 |
527 |
$1K |
| 67820 |
|
13 |
13 |
$364.77 |