| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92083 |
|
2,720 |
2,577 |
$98K |
| 92250 |
|
2,485 |
2,355 |
$95K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,373 |
2,261 |
$90K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,572 |
2,417 |
$88K |
| 76512 |
|
1,506 |
894 |
$65K |
| V2020 |
Frames, purchases |
2,933 |
2,802 |
$53K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,246 |
1,180 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
851 |
659 |
$12K |
| 92285 |
|
321 |
293 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
245 |
245 |
$6K |
| V2025 |
Deluxe frame |
283 |
277 |
$5K |
| 68761 |
|
104 |
58 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
133 |
122 |
$3K |
| 68801 |
|
106 |
58 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
641 |
486 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
64 |
61 |
$2K |
| 76514 |
|
421 |
385 |
$1K |
| 92286 |
|
12 |
12 |
$720.06 |
| 92225 |
|
39 |
24 |
$564.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$470.64 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
92 |
91 |
$450.00 |
| 92015 |
Determination of refractive state |
500 |
485 |
$21.56 |
| V2755 |
U-v lens, per lens |
170 |
85 |
$0.00 |