| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,934 |
1,933 |
$214K |
| 92250 |
|
1,987 |
1,985 |
$70K |
| 68761 |
|
352 |
352 |
$61K |
| 92083 |
|
1,058 |
1,058 |
$55K |
| V2020 |
Frames, purchases |
1,072 |
1,072 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
442 |
441 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
602 |
602 |
$41K |
| 92015 |
Determination of refractive state |
1,436 |
1,436 |
$24K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
189 |
189 |
$20K |
| 92225 |
|
752 |
454 |
$13K |
| 76512 |
|
170 |
85 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
340 |
340 |
$9K |
| 93886 |
|
54 |
54 |
$7K |
| 93892 |
|
54 |
54 |
$5K |
| 93890 |
|
54 |
54 |
$5K |
| 92341 |
|
123 |
123 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
49 |
49 |
$3K |
| 68801 |
|
38 |
38 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
29 |
29 |
$2K |
| 92133 |
|
38 |
38 |
$1K |
| V2219 |
Bifocal seg width over 28 mm |
13 |
13 |
$1K |
| 92202 |
|
52 |
51 |
$491.78 |
| 92285 |
|
12 |
12 |
$220.98 |