| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
12,092 |
12,001 |
$499K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,996 |
8,930 |
$432K |
| 76512 |
|
7,635 |
4,154 |
$430K |
| 92083 |
|
9,856 |
9,753 |
$392K |
| 92285 |
|
10,000 |
9,927 |
$304K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,357 |
5,327 |
$271K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,477 |
8,276 |
$206K |
| V2020 |
Frames, purchases |
10,391 |
10,288 |
$158K |
| 92286 |
|
3,127 |
3,106 |
$125K |
| 68761 |
|
1,697 |
820 |
$103K |
| 92060 |
|
3,338 |
3,320 |
$90K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,801 |
1,661 |
$64K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,065 |
1,000 |
$27K |
| 92025 |
|
1,226 |
1,218 |
$18K |
| 92020 |
|
1,212 |
1,195 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,056 |
844 |
$9K |
| 76514 |
|
1,459 |
1,389 |
$9K |
| 92015 |
Determination of refractive state |
1,710 |
1,709 |
$7K |
| 92134 |
|
267 |
267 |
$7K |
| 92225 |
|
306 |
152 |
$6K |
| 92133 |
|
169 |
169 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
110 |
55 |
$2K |
| 92202 |
|
13 |
13 |
$8.24 |