| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,785 |
2,770 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,509 |
2,503 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
450 |
393 |
$16K |
| 92225 |
|
269 |
267 |
$12K |
| V2020 |
Frames, purchases |
4,465 |
4,389 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,529 |
2,891 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,207 |
1,364 |
$6K |
| 92015 |
Determination of refractive state |
637 |
633 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
916 |
597 |
$2K |
| 92250 |
|
16 |
16 |
$373.40 |
| 92202 |
|
51 |
47 |
$318.05 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
125 |
87 |
$260.00 |
| 92082 |
|
15 |
15 |
$192.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
31 |
31 |
$0.00 |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
12 |
12 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
42 |
42 |
$0.00 |