| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
17,096 |
17,048 |
$788K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
9,907 |
9,864 |
$716K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,476 |
4,466 |
$268K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
4,516 |
4,508 |
$258K |
| 92285 |
|
12,091 |
11,914 |
$256K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15,197 |
10,250 |
$241K |
| V2020 |
Frames, purchases |
19,766 |
19,573 |
$236K |
| 92083 |
|
4,428 |
4,389 |
$218K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,104 |
4,836 |
$211K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,245 |
3,232 |
$121K |
| 92133 |
|
4,068 |
4,050 |
$104K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,125 |
6,093 |
$82K |
| V2219 |
Bifocal seg width over 28 mm |
1,298 |
1,292 |
$82K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
3,360 |
2,211 |
$73K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,916 |
2,754 |
$69K |
| 68761 |
|
917 |
566 |
$67K |
| 92132 |
|
2,003 |
2,000 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,441 |
4,459 |
$40K |
| 92015 |
Determination of refractive state |
3,226 |
3,226 |
$38K |
| 92060 |
|
756 |
752 |
$28K |
| 76514 |
|
3,576 |
3,567 |
$26K |
| 92341 |
|
1,390 |
1,387 |
$24K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,294 |
4,373 |
$20K |
| 92202 |
|
1,046 |
899 |
$18K |
| 92134 |
|
761 |
753 |
$17K |
| 92286 |
|
355 |
354 |
$9K |
| 92201 |
|
652 |
535 |
$8K |
| 92225 |
|
470 |
283 |
$8K |
| 92020 |
|
508 |
506 |
$7K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
238 |
238 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
466 |
425 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
92 |
92 |
$4K |
| 76512 |
|
31 |
29 |
$3K |
| V2780 |
Oversize lens, per lens |
161 |
161 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
139 |
120 |
$1K |
| 92002 |
|
29 |
29 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
166 |
86 |
$1K |
| 92025 |
|
81 |
81 |
$714.04 |
| V2025 |
Deluxe frame |
26 |
26 |
$0.00 |