| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,759 |
5,696 |
$273K |
| 92286 |
|
3,785 |
3,774 |
$263K |
| 92083 |
|
5,077 |
5,054 |
$233K |
| 92250 |
|
5,162 |
5,146 |
$212K |
| V2020 |
Frames, purchases |
8,717 |
8,588 |
$202K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,558 |
7,441 |
$172K |
| 92285 |
|
3,144 |
3,130 |
$169K |
| 76512 |
|
3,232 |
1,959 |
$147K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,313 |
2,307 |
$110K |
| 92060 |
|
2,205 |
2,201 |
$63K |
| 92025 |
|
1,339 |
1,335 |
$23K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
549 |
541 |
$16K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
407 |
394 |
$13K |
| 68761 |
|
276 |
141 |
$12K |
| 92020 |
|
1,203 |
1,198 |
$12K |
| 92134 |
|
282 |
280 |
$8K |
| 76514 |
|
1,144 |
1,135 |
$7K |
| 92133 |
|
267 |
266 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
291 |
290 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
690 |
665 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
74 |
73 |
$1K |
| 92225 |
|
28 |
18 |
$450.88 |
| 92341 |
|
12 |
12 |
$240.00 |
| V2025 |
Deluxe frame |
12 |
12 |
$0.00 |