| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
4,792 |
4,781 |
$210K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,970 |
2,963 |
$206K |
| 76512 |
|
3,296 |
1,694 |
$197K |
| 92083 |
|
3,543 |
3,511 |
$167K |
| 92060 |
|
4,076 |
4,058 |
$146K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,830 |
1,826 |
$101K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,475 |
1,847 |
$64K |
| 92286 |
|
976 |
975 |
$58K |
| 92285 |
|
1,766 |
1,760 |
$43K |
| V2020 |
Frames, purchases |
2,331 |
2,288 |
$27K |
| 68761 |
|
315 |
155 |
$23K |
| 92020 |
|
1,140 |
1,139 |
$16K |
| 92015 |
Determination of refractive state |
775 |
775 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
310 |
298 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
423 |
423 |
$6K |
| 76514 |
|
325 |
325 |
$2K |
| 92133 |
|
58 |
57 |
$2K |
| 92025 |
|
108 |
108 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$988.88 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$369.72 |