| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
7,706 |
7,681 |
$314K |
| V2020 |
Frames, purchases |
11,597 |
11,550 |
$236K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
9,623 |
9,584 |
$200K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,688 |
4,666 |
$179K |
| 92225 |
|
3,482 |
1,826 |
$162K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,901 |
3,879 |
$138K |
| 92015 |
Determination of refractive state |
12,841 |
12,779 |
$99K |
| 92133 |
|
2,358 |
2,348 |
$88K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,788 |
2,783 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,719 |
1,690 |
$62K |
| 92341 |
|
1,970 |
1,967 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,323 |
2,246 |
$55K |
| 92201 |
|
2,160 |
2,126 |
$52K |
| 99215 |
Prolong outpt/office vis |
750 |
740 |
$39K |
| 92083 |
|
1,562 |
1,553 |
$36K |
| 92082 |
|
1,139 |
1,137 |
$28K |
| 92025 |
|
1,067 |
1,067 |
$27K |
| 99205 |
Prolong outpt/office vis |
355 |
355 |
$26K |
| 92134 |
|
548 |
547 |
$19K |
| 92020 |
|
862 |
859 |
$14K |
| 76514 |
|
436 |
436 |
$4K |
| 92202 |
|
263 |
262 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
126 |
126 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
107 |
107 |
$847.44 |