| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,293 |
2,288 |
$156K |
| 92250 |
|
2,707 |
2,700 |
$126K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
547 |
542 |
$30K |
| 92015 |
Determination of refractive state |
2,472 |
2,470 |
$29K |
| 92083 |
|
273 |
272 |
$14K |
| 92285 |
|
917 |
914 |
$12K |
| 92060 |
|
253 |
252 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
658 |
655 |
$9K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
29 |
29 |
$9K |
| V2219 |
Bifocal seg width over 28 mm |
94 |
92 |
$8K |
| V2020 |
Frames, purchases |
811 |
806 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
155 |
153 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
64 |
64 |
$5K |
| 92225 |
|
102 |
100 |
$3K |
| 92341 |
|
126 |
124 |
$2K |
| 92202 |
|
135 |
135 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
217 |
217 |
$2K |
| 92020 |
|
103 |
103 |
$1K |
| 68761 |
|
12 |
12 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
82 |
$732.60 |
| 92133 |
|
13 |
13 |
$373.55 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$322.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
16 |
$302.40 |
| 3072F |
|
72 |
68 |
$0.00 |