| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
318 |
258 |
$221K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,498 |
1,398 |
$51K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,211 |
1,069 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
613 |
534 |
$27K |
| 92133 |
|
451 |
420 |
$8K |
| 92250 |
|
255 |
233 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
158 |
120 |
$4K |
| 92015 |
Determination of refractive state |
167 |
134 |
$2K |
| V2025 |
Deluxe frame |
96 |
67 |
$2K |
| 92136 |
|
39 |
37 |
$1K |
| 92134 |
|
41 |
39 |
$571.47 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
16 |
$390.00 |
| 92083 |
|
13 |
13 |
$376.24 |
| 92020 |
|
12 |
12 |
$215.03 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
18 |
$125.20 |