| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,698 |
5,683 |
$566K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,650 |
4,415 |
$326K |
| V2020 |
Frames, purchases |
7,152 |
7,121 |
$311K |
| 92250 |
|
7,686 |
7,672 |
$294K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,124 |
2,122 |
$253K |
| 68761 |
|
1,489 |
1,461 |
$237K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,233 |
4,196 |
$206K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,810 |
6,759 |
$193K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,410 |
2,389 |
$123K |
| V2219 |
Bifocal seg width over 28 mm |
1,576 |
1,560 |
$119K |
| 92015 |
Determination of refractive state |
8,377 |
8,346 |
$115K |
| 92082 |
|
2,643 |
2,641 |
$104K |
| 67700 |
|
284 |
282 |
$96K |
| 92310 |
|
1,181 |
1,031 |
$94K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,127 |
1,115 |
$83K |
| 92083 |
|
1,337 |
1,331 |
$68K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
924 |
912 |
$61K |
| 92341 |
|
1,739 |
1,724 |
$56K |
| 92285 |
|
2,511 |
2,461 |
$49K |
| 92133 |
|
1,132 |
1,127 |
$33K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,846 |
1,823 |
$24K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
271 |
268 |
$17K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
238 |
236 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
228 |
227 |
$10K |
| 92132 |
|
123 |
123 |
$3K |
| 92002 |
|
39 |
39 |
$3K |
| 76512 |
|
12 |
12 |
$934.76 |
| 92025 |
|
16 |
14 |
$651.70 |
| 76514 |
|
14 |
14 |
$127.53 |