| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,713 |
6,695 |
$494K |
| 92250 |
|
9,730 |
9,634 |
$438K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,541 |
4,526 |
$264K |
| 92083 |
|
5,587 |
5,530 |
$262K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,933 |
5,162 |
$153K |
| 76512 |
|
2,301 |
1,507 |
$144K |
| 68761 |
|
1,706 |
1,281 |
$139K |
| V2020 |
Frames, purchases |
8,601 |
8,425 |
$122K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,045 |
1,933 |
$80K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,873 |
1,436 |
$60K |
| 92133 |
|
764 |
757 |
$22K |
| 92285 |
|
1,231 |
1,163 |
$22K |
| 68801 |
|
338 |
316 |
$21K |
| 92225 |
|
700 |
432 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,330 |
760 |
$9K |
| 92015 |
Determination of refractive state |
707 |
705 |
$8K |
| 92020 |
|
562 |
551 |
$8K |
| 92002 |
|
173 |
168 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,854 |
1,494 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
385 |
377 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
392 |
211 |
$3K |
| 92202 |
|
77 |
76 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
34 |
33 |
$2K |
| 92060 |
|
32 |
32 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$530.50 |
| 76514 |
|
58 |
58 |
$470.86 |
| 92132 |
|
34 |
33 |
$365.70 |
| V2755 |
U-v lens, per lens |
840 |
416 |
$0.00 |
| 92025 |
|
61 |
60 |
$0.00 |