| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,398 |
3,204 |
$103K |
| 92083 |
|
3,677 |
3,467 |
$94K |
| 68761 |
|
2,699 |
586 |
$87K |
| 92250 |
|
3,433 |
3,226 |
$79K |
| V2020 |
Frames, purchases |
564 |
483 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
679 |
514 |
$31K |
| 92015 |
Determination of refractive state |
3,082 |
2,896 |
$29K |
| 92273 |
|
352 |
258 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
343 |
323 |
$19K |
| 92133 |
|
1,015 |
946 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
601 |
523 |
$14K |
| V2025 |
Deluxe frame |
284 |
251 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
156 |
150 |
$9K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
98 |
68 |
$7K |
| 92225 |
|
538 |
314 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
166 |
146 |
$3K |
| 92132 |
|
1,072 |
996 |
$3K |
| V2756 |
Eye glass case |
1,500 |
1,347 |
$3K |
| 92341 |
|
77 |
77 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
28 |
24 |
$265.76 |
| 76514 |
|
13 |
13 |
$132.39 |
| 99072 |
|
12 |
12 |
$36.06 |
| A4550 |
Surgical trays |
101 |
79 |
$20.64 |
| A4262 |
Temporary, absorbable lacrimal duct implant, each |
553 |
442 |
$0.00 |