| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76512 |
|
5,339 |
2,759 |
$300K |
| 92250 |
|
4,770 |
4,741 |
$201K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,706 |
2,695 |
$182K |
| 92083 |
|
3,517 |
3,486 |
$156K |
| 92285 |
|
4,922 |
4,874 |
$117K |
| 92060 |
|
2,932 |
2,923 |
$106K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,857 |
1,852 |
$99K |
| 92286 |
|
877 |
872 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,498 |
1,388 |
$48K |
| V2020 |
Frames, purchases |
2,475 |
2,472 |
$30K |
| 68761 |
|
176 |
87 |
$11K |
| 92015 |
Determination of refractive state |
558 |
553 |
$10K |
| 92225 |
|
236 |
123 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
68 |
65 |
$2K |
| 92020 |
|
202 |
200 |
$2K |
| 76514 |
|
322 |
320 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
107 |
105 |
$2K |
| 92133 |
|
57 |
57 |
$1K |
| 92025 |
|
108 |
108 |
$979.69 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$287.54 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,234 |
616 |
$190.00 |
| 3072F |
|
18 |
18 |
$0.00 |