| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
2,500 |
2,284 |
$72K |
| 92060 |
|
2,037 |
1,760 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,846 |
1,724 |
$50K |
| 92015 |
Determination of refractive state |
2,016 |
1,874 |
$48K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,637 |
1,507 |
$46K |
| 92065 |
|
1,033 |
436 |
$31K |
| 92025 |
|
1,607 |
1,455 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,831 |
1,308 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
489 |
458 |
$24K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
1,034 |
435 |
$20K |
| V2020 |
Frames, purchases |
1,393 |
1,283 |
$20K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
1,035 |
435 |
$19K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
1,034 |
435 |
$18K |
| 97129 |
|
980 |
409 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
440 |
355 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
119 |
111 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
158 |
134 |
$6K |
| 92083 |
|
153 |
129 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
27 |
$2K |
| 92134 |
|
135 |
121 |
$2K |
| 95930 |
|
64 |
56 |
$1K |
| 0509T |
|
52 |
44 |
$1K |
| 92273 |
|
16 |
14 |
$1K |
| 92133 |
|
56 |
49 |
$884.91 |
| 92283 |
|
36 |
30 |
$420.51 |
| 92020 |
|
28 |
24 |
$402.67 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
347 |
131 |
$179.91 |
| 76514 |
|
15 |
12 |
$93.40 |
| G0515 |
Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes |
46 |
24 |
$0.00 |
| 97533 |
|
1,033 |
435 |
$0.00 |
| 99072 |
|
109 |
98 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |