| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,320 |
8,308 |
$585K |
| 92250 |
|
12,650 |
12,620 |
$581K |
| 76512 |
|
7,469 |
5,295 |
$552K |
| 92083 |
|
9,167 |
9,070 |
$445K |
| 92286 |
|
4,991 |
4,984 |
$411K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,440 |
4,436 |
$255K |
| 92285 |
|
12,434 |
12,371 |
$225K |
| 92060 |
|
5,163 |
5,146 |
$192K |
| 68761 |
|
1,816 |
1,553 |
$177K |
| 92015 |
Determination of refractive state |
6,984 |
6,974 |
$83K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,556 |
2,930 |
$66K |
| V2020 |
Frames, purchases |
5,760 |
5,737 |
$51K |
| 92020 |
|
3,503 |
3,491 |
$46K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,100 |
1,050 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,878 |
2,877 |
$38K |
| 92025 |
|
1,513 |
1,513 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,163 |
2,086 |
$20K |
| 92133 |
|
443 |
442 |
$13K |
| 76514 |
|
1,596 |
1,594 |
$13K |
| 92341 |
|
528 |
528 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
283 |
201 |
$6K |
| 92134 |
|
159 |
157 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
259 |
259 |
$5K |
| 92225 |
|
80 |
80 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
116 |
116 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,245 |
632 |
$1K |
| 92202 |
|
14 |
14 |
$129.78 |