| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,889 |
2,888 |
$206K |
| 92083 |
|
3,528 |
3,451 |
$166K |
| 92250 |
|
3,639 |
3,628 |
$157K |
| 76512 |
|
1,647 |
871 |
$94K |
| 92060 |
|
2,461 |
2,456 |
$89K |
| 92285 |
|
3,318 |
3,287 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
819 |
817 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,830 |
1,485 |
$44K |
| V2020 |
Frames, purchases |
2,225 |
2,219 |
$27K |
| 92286 |
|
509 |
509 |
$18K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
278 |
143 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
122 |
114 |
$5K |
| 92020 |
|
298 |
297 |
$4K |
| 76514 |
|
332 |
332 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$959.78 |
| 92133 |
|
26 |
25 |
$744.77 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
32 |
32 |
$484.80 |
| 92015 |
Determination of refractive state |
14 |
14 |
$212.80 |
| 92025 |
|
12 |
12 |
$131.24 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$41.08 |