| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
7,263 |
7,242 |
$337K |
| 76512 |
|
5,098 |
2,723 |
$319K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,946 |
3,932 |
$283K |
| 92083 |
|
5,637 |
5,565 |
$274K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,096 |
3,092 |
$183K |
| 92285 |
|
6,337 |
6,307 |
$169K |
| 92060 |
|
3,549 |
3,536 |
$132K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,049 |
2,990 |
$99K |
| 92286 |
|
1,069 |
1,069 |
$91K |
| V2020 |
Frames, purchases |
4,262 |
4,213 |
$36K |
| 92015 |
Determination of refractive state |
1,582 |
1,582 |
$33K |
| 68761 |
|
447 |
209 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,001 |
999 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
207 |
191 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
700 |
349 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
144 |
71 |
$4K |
| 92020 |
|
165 |
163 |
$2K |
| 92133 |
|
67 |
67 |
$2K |
| 76514 |
|
221 |
220 |
$2K |
| 92134 |
|
76 |
75 |
$2K |
| 92025 |
|
70 |
70 |
$1K |
| 92341 |
|
44 |
43 |
$840.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
250 |
122 |
$0.00 |