| Code | Description | Claims | Beneficiaries | Total Paid |
| 92083 |
|
4,645 |
4,495 |
$230K |
| 92250 |
|
4,080 |
4,041 |
$188K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,071 |
2,057 |
$138K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,206 |
1,200 |
$101K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,426 |
1,417 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,028 |
1,014 |
$57K |
| V2020 |
Frames, purchases |
4,086 |
4,015 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,791 |
1,517 |
$39K |
| 92133 |
|
1,112 |
1,105 |
$33K |
| 92015 |
Determination of refractive state |
1,558 |
1,555 |
$18K |
| 92020 |
|
1,111 |
1,078 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
332 |
319 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
856 |
848 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,193 |
814 |
$9K |
| 92132 |
|
383 |
380 |
$9K |
| 76514 |
|
1,011 |
1,002 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
277 |
191 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,260 |
682 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
327 |
222 |
$4K |
| 92341 |
|
230 |
226 |
$4K |
| 68761 |
|
24 |
12 |
$2K |
| 92082 |
|
27 |
27 |
$1K |
| 92002 |
|
32 |
32 |
$1K |
| V2219 |
Bifocal seg width over 28 mm |
15 |
15 |
$831.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
24 |
24 |
$593.53 |
| 92285 |
|
12 |
12 |
$95.52 |
| V2755 |
U-v lens, per lens |
424 |
209 |
$0.00 |