| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,490 |
3,472 |
$338K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,835 |
3,818 |
$328K |
| 92083 |
|
4,351 |
4,332 |
$223K |
| 92250 |
|
3,766 |
3,752 |
$148K |
| 76512 |
|
2,015 |
1,482 |
$142K |
| 68761 |
|
855 |
651 |
$116K |
| V2020 |
Frames, purchases |
3,327 |
3,308 |
$112K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,393 |
1,268 |
$73K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,726 |
1,794 |
$73K |
| 68801 |
|
528 |
459 |
$42K |
| 92015 |
Determination of refractive state |
2,954 |
2,900 |
$24K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
314 |
307 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
398 |
397 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
125 |
124 |
$12K |
| 92285 |
|
399 |
397 |
$9K |
| 76514 |
|
837 |
834 |
$8K |
| 92286 |
|
132 |
132 |
$5K |
| 92133 |
|
57 |
57 |
$1K |
| 92134 |
|
40 |
40 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$883.96 |
| 92020 |
|
33 |
32 |
$479.39 |
| 92202 |
|
14 |
14 |
$226.77 |
| 92201 |
|
15 |
12 |
$181.72 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
344 |
172 |
$36.00 |
| 2022F |
|
13 |
13 |
$0.00 |