| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
11,377 |
10,999 |
$378K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,862 |
8,571 |
$251K |
| 76512 |
|
4,144 |
1,941 |
$154K |
| 92083 |
|
9,310 |
8,942 |
$139K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,745 |
3,568 |
$110K |
| 68761 |
|
2,480 |
1,067 |
$63K |
| 92285 |
|
3,236 |
2,940 |
$45K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,790 |
1,620 |
$45K |
| 92020 |
|
3,508 |
3,293 |
$43K |
| 92060 |
|
2,163 |
2,049 |
$39K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,865 |
1,533 |
$38K |
| 92286 |
|
4,228 |
3,953 |
$37K |
| 92133 |
|
1,128 |
1,059 |
$24K |
| V2020 |
Frames, purchases |
4,188 |
4,055 |
$21K |
| 92025 |
|
1,969 |
1,875 |
$20K |
| 76514 |
|
2,571 |
2,435 |
$18K |
| 92015 |
Determination of refractive state |
4,599 |
4,168 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,153 |
2,918 |
$15K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
689 |
493 |
$7K |
| 92202 |
|
894 |
856 |
$6K |
| 92134 |
|
191 |
180 |
$4K |
| 92225 |
|
111 |
65 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
298 |
146 |
$0.00 |
| 2024F |
|
13 |
13 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
28 |
$0.00 |