| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
6,455 |
6,424 |
$280K |
| 68761 |
|
3,852 |
1,892 |
$267K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,516 |
2,502 |
$168K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,613 |
2,590 |
$149K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,564 |
2,562 |
$138K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,953 |
2,948 |
$107K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,118 |
3,574 |
$106K |
| 92083 |
|
1,994 |
1,960 |
$90K |
| V2020 |
Frames, purchases |
7,108 |
7,062 |
$82K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,598 |
2,385 |
$59K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,322 |
1,185 |
$51K |
| 92133 |
|
3,403 |
3,394 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
729 |
729 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
305 |
216 |
$8K |
| 92285 |
|
301 |
296 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
87 |
87 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
948 |
664 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
100 |
99 |
$6K |
| 92015 |
Determination of refractive state |
327 |
327 |
$4K |
| 92225 |
|
263 |
142 |
$3K |
| 92202 |
|
243 |
135 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,867 |
1,087 |
$2K |
| 92286 |
|
26 |
25 |
$2K |
| 92226 |
|
83 |
45 |
$952.16 |
| 92134 |
|
68 |
68 |
$575.62 |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
13 |
13 |
$471.24 |
| V2780 |
Oversize lens, per lens |
31 |
31 |
$366.56 |
| 76514 |
|
18 |
16 |
$106.75 |