| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
5,075 |
5,033 |
$186K |
| 92082 |
|
4,176 |
4,140 |
$60K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
119 |
114 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97 |
90 |
$2K |
| 92133 |
|
53 |
53 |
$1K |
| 92083 |
|
63 |
63 |
$976.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
27 |
$665.01 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,992 |
7,946 |
$423.00 |
| 92134 |
|
13 |
12 |
$271.37 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,844 |
1,835 |
$264.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
185 |
99 |
$57.16 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,373 |
4,963 |
$41.08 |
| V2020 |
Frames, purchases |
6,647 |
6,477 |
$23.00 |
| V2750 |
Anti-reflective coating, per lens |
3,022 |
1,502 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
242 |
237 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
14 |
14 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
30 |
13 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,526 |
3,888 |
$0.00 |
| V2781 |
Progressive lens, per lens |
904 |
448 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
690 |
335 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
764 |
371 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,458 |
747 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
414 |
218 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
147 |
147 |
$0.00 |