| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92065 |
|
11,330 |
4,269 |
$342K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,945 |
5,640 |
$269K |
| 92060 |
|
5,893 |
5,541 |
$196K |
| 92015 |
Determination of refractive state |
6,415 |
6,061 |
$187K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,829 |
1,689 |
$140K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,382 |
3,185 |
$98K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,398 |
2,265 |
$89K |
| V2020 |
Frames, purchases |
2,744 |
2,511 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
702 |
654 |
$42K |
| 92544 |
|
1,478 |
1,344 |
$29K |
| 92545 |
|
1,454 |
1,324 |
$25K |
| 92002 |
|
324 |
314 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
707 |
681 |
$12K |
| 92066 |
|
680 |
281 |
$12K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
154 |
63 |
$6K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
154 |
63 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
321 |
304 |
$6K |
| 92133 |
|
160 |
157 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$101.74 |
| V2756 |
Eye glass case |
15 |
15 |
$0.00 |