| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92083 |
|
3,337 |
3,332 |
$175K |
| 92250 |
|
3,077 |
3,071 |
$151K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,106 |
2,104 |
$127K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,439 |
1,437 |
$104K |
| 92134 |
|
3,109 |
3,104 |
$94K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,557 |
5,463 |
$75K |
| 76512 |
|
613 |
613 |
$63K |
| V2020 |
Frames, purchases |
5,867 |
5,763 |
$59K |
| 92015 |
Determination of refractive state |
3,400 |
3,398 |
$39K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,532 |
1,503 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,261 |
2,234 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,099 |
2,062 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
389 |
387 |
$17K |
| 92341 |
|
539 |
533 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
44 |
44 |
$793.80 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$331.20 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$269.10 |