| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,395 |
1,207 |
$38K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,834 |
1,450 |
$27K |
| 92015 |
Determination of refractive state |
946 |
700 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
311 |
259 |
$8K |
| 92250 |
|
299 |
252 |
$1K |
| 92225 |
|
223 |
110 |
$901.08 |
| 92020 |
|
534 |
474 |
$716.38 |
| 92133 |
|
922 |
749 |
$586.70 |
| 92083 |
|
94 |
86 |
$248.30 |
| 92134 |
|
205 |
159 |
$177.70 |
| 92132 |
|
62 |
41 |
$82.74 |
| 92201 |
|
124 |
98 |
$69.26 |
| 76514 |
|
122 |
111 |
$32.94 |
| V2781 |
Progressive lens, per lens |
661 |
274 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,039 |
299 |
$0.00 |
| V2755 |
U-v lens, per lens |
829 |
299 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
474 |
299 |
$0.00 |
| 92286 |
|
37 |
37 |
$0.00 |
| V2020 |
Frames, purchases |
518 |
344 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
255 |
59 |
$0.00 |
| V2730 |
Special base curve, glass or plastic, per lens |
176 |
59 |
$0.00 |
| V2199 |
Not otherwise classified, single vision lens |
440 |
275 |
$0.00 |
| 92025 |
|
26 |
26 |
$0.00 |
| 76512 |
|
35 |
12 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
247 |
58 |
$0.00 |
| V2300 |
Sphere, trifocal, plano to plus or minus 4.00d, per lens |
421 |
51 |
$0.00 |
| 92145 |
|
57 |
28 |
$0.00 |