| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
11,486 |
11,169 |
$473K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,395 |
8,344 |
$443K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,879 |
4,837 |
$319K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,757 |
6,576 |
$252K |
| 92083 |
|
4,517 |
4,419 |
$195K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12,803 |
6,371 |
$178K |
| V2020 |
Frames, purchases |
10,641 |
10,454 |
$120K |
| 92132 |
|
3,995 |
3,969 |
$99K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
4,092 |
2,037 |
$69K |
| 92133 |
|
2,560 |
2,535 |
$68K |
| 92202 |
|
2,099 |
2,092 |
$48K |
| 92285 |
|
2,049 |
1,972 |
$48K |
| 68761 |
|
440 |
239 |
$26K |
| 92134 |
|
1,001 |
994 |
$25K |
| 92226 |
|
716 |
361 |
$9K |
| 76514 |
|
1,105 |
1,101 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
190 |
186 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,616 |
872 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
441 |
441 |
$5K |
| 92341 |
|
200 |
199 |
$4K |
| 76512 |
|
58 |
37 |
$3K |
| 92225 |
|
254 |
129 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
639 |
383 |
$3K |
| 92020 |
|
95 |
95 |
$1K |
| 92002 |
|
13 |
13 |
$621.10 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
58 |
29 |
$205.40 |
| 92015 |
Determination of refractive state |
887 |
883 |
$36.65 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,330 |
2,621 |
$30.00 |
| V2755 |
U-v lens, per lens |
46 |
23 |
$0.00 |