| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 68761 |
|
5,101 |
3,878 |
$428K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,307 |
4,055 |
$350K |
| V2020 |
Frames, purchases |
5,294 |
4,922 |
$190K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,769 |
1,682 |
$176K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,407 |
2,150 |
$111K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,512 |
2,348 |
$90K |
| 92015 |
Determination of refractive state |
6,247 |
5,916 |
$74K |
| 67820 |
|
3,896 |
2,799 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,576 |
1,461 |
$57K |
| 92250 |
|
1,233 |
1,145 |
$41K |
| V2755 |
U-v lens, per lens |
1,362 |
1,281 |
$31K |
| 65205 |
|
1,240 |
1,120 |
$28K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
653 |
602 |
$26K |
| 92083 |
|
519 |
500 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
760 |
674 |
$15K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
168 |
152 |
$9K |
| 92133 |
|
41 |
41 |
$782.89 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
13 |
$750.56 |