| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,990 |
1,990 |
$135K |
| 92250 |
|
2,866 |
2,865 |
$127K |
| 92083 |
|
2,341 |
2,338 |
$110K |
| 92286 |
|
1,199 |
1,199 |
$93K |
| 76512 |
|
882 |
580 |
$67K |
| 92285 |
|
2,569 |
2,563 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
700 |
700 |
$37K |
| 92060 |
|
866 |
866 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,124 |
697 |
$19K |
| 92025 |
|
902 |
902 |
$19K |
| 92015 |
Determination of refractive state |
1,387 |
1,387 |
$15K |
| V2020 |
Frames, purchases |
1,551 |
1,550 |
$15K |
| 92020 |
|
970 |
970 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,013 |
1,013 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
803 |
803 |
$6K |
| 76514 |
|
582 |
582 |
$5K |
| 68761 |
|
14 |
12 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
87 |
87 |
$1K |
| 92341 |
|
41 |
41 |
$720.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$515.84 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$445.05 |