| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,549 |
4,138 |
$322K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,573 |
4,598 |
$223K |
| 92250 |
|
4,767 |
4,721 |
$212K |
| 76512 |
|
6,713 |
3,343 |
$177K |
| 92083 |
|
4,529 |
4,496 |
$158K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,284 |
1,273 |
$134K |
| 92133 |
|
3,205 |
3,176 |
$82K |
| 92020 |
|
4,512 |
4,477 |
$61K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
963 |
950 |
$56K |
| 92136 |
|
1,164 |
680 |
$34K |
| 92015 |
Determination of refractive state |
2,101 |
2,048 |
$32K |
| 92025 |
|
1,290 |
1,277 |
$25K |
| 92134 |
|
1,585 |
1,562 |
$25K |
| V2020 |
Frames, purchases |
770 |
752 |
$23K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
159 |
158 |
$11K |
| 76514 |
|
1,236 |
1,220 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
127 |
126 |
$7K |
| 92285 |
|
949 |
930 |
$7K |
| 92286 |
|
323 |
320 |
$5K |
| 92310 |
|
63 |
57 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
47 |
$985.43 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$182.00 |