| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
883 |
883 |
$61K |
| 92250 |
|
1,173 |
1,171 |
$58K |
| 76512 |
|
553 |
530 |
$53K |
| 92083 |
|
972 |
967 |
$51K |
| 92286 |
|
563 |
563 |
$49K |
| 92285 |
|
1,178 |
1,173 |
$15K |
| 92015 |
Determination of refractive state |
1,192 |
1,191 |
$14K |
| 92060 |
|
307 |
307 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
128 |
128 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
534 |
534 |
$7K |
| V2020 |
Frames, purchases |
659 |
659 |
$4K |
| 92020 |
|
211 |
209 |
$3K |
| 68801 |
|
30 |
30 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
235 |
235 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
108 |
108 |
$837.00 |
| 92341 |
|
27 |
27 |
$486.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$414.00 |
| 92025 |
|
12 |
12 |
$271.73 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$198.00 |