| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,823 |
6,816 |
$514K |
| 92083 |
|
10,222 |
10,120 |
$507K |
| 92250 |
|
10,009 |
9,974 |
$468K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,012 |
6,998 |
$430K |
| 68761 |
|
3,511 |
3,306 |
$348K |
| 76512 |
|
1,805 |
1,461 |
$139K |
| 68801 |
|
2,097 |
2,038 |
$127K |
| V2020 |
Frames, purchases |
10,653 |
10,479 |
$114K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,822 |
3,948 |
$112K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,561 |
2,476 |
$108K |
| 92133 |
|
2,601 |
2,581 |
$77K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,559 |
1,285 |
$53K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,085 |
2,972 |
$41K |
| 92015 |
Determination of refractive state |
3,031 |
3,028 |
$38K |
| V2219 |
Bifocal seg width over 28 mm |
463 |
462 |
$35K |
| 92225 |
|
1,219 |
951 |
$27K |
| 92020 |
|
1,419 |
1,351 |
$20K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,398 |
986 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,771 |
1,970 |
$15K |
| 92285 |
|
520 |
518 |
$10K |
| 92002 |
|
210 |
208 |
$9K |
| 76514 |
|
800 |
790 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
267 |
263 |
$6K |
| 92226 |
|
124 |
111 |
$3K |
| 92341 |
|
108 |
108 |
$3K |
| 92082 |
|
46 |
46 |
$2K |
| 92202 |
|
77 |
77 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
18 |
$991.98 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
31 |
31 |
$432.00 |
| 2033F |
|
50 |
50 |
$0.00 |
| V2755 |
U-v lens, per lens |
652 |
326 |
$0.00 |