| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
5,717 |
5,710 |
$285K |
| 92286 |
|
2,716 |
2,715 |
$232K |
| 92083 |
|
4,238 |
4,215 |
$224K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,104 |
3,103 |
$220K |
| 76512 |
|
1,324 |
1,274 |
$125K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,093 |
2,093 |
$125K |
| 92060 |
|
2,520 |
2,519 |
$95K |
| 92015 |
Determination of refractive state |
5,792 |
5,789 |
$75K |
| 92285 |
|
4,896 |
4,892 |
$67K |
| 68761 |
|
483 |
471 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,315 |
2,315 |
$31K |
| 92020 |
|
1,641 |
1,638 |
$22K |
| 92025 |
|
976 |
976 |
$22K |
| V2020 |
Frames, purchases |
2,359 |
2,359 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,393 |
1,393 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
897 |
897 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
176 |
168 |
$7K |
| 76514 |
|
716 |
715 |
$6K |
| 92133 |
|
180 |
180 |
$5K |
| 92341 |
|
208 |
208 |
$4K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
77 |
77 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
52 |
$921.15 |
| 92225 |
|
29 |
29 |
$729.00 |