| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12,892 |
12,784 |
$806K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,179 |
8,116 |
$635K |
| 92083 |
|
12,668 |
12,530 |
$591K |
| 76512 |
|
9,843 |
5,667 |
$581K |
| 92250 |
|
12,178 |
12,072 |
$515K |
| V2020 |
Frames, purchases |
10,176 |
10,075 |
$172K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,813 |
5,657 |
$164K |
| 68761 |
|
1,285 |
742 |
$102K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,826 |
1,727 |
$59K |
| 68801 |
|
937 |
523 |
$53K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,229 |
1,181 |
$49K |
| 92285 |
|
1,867 |
1,831 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,242 |
1,230 |
$34K |
| 92015 |
Determination of refractive state |
3,050 |
3,025 |
$23K |
| 92225 |
|
1,402 |
789 |
$21K |
| 76514 |
|
2,902 |
2,852 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
735 |
459 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,435 |
1,936 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
202 |
107 |
$2K |
| 92133 |
|
55 |
54 |
$2K |
| 92226 |
|
116 |
65 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
75 |
75 |
$1K |
| 92002 |
|
12 |
12 |
$551.10 |
| 92201 |
|
41 |
40 |
$528.45 |
| 92020 |
|
27 |
26 |
$355.47 |
| 92202 |
|
27 |
14 |
$286.78 |
| 2022F |
|
63 |
63 |
$0.00 |
| G8397 |
Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy |
271 |
271 |
$0.00 |
| V2755 |
U-v lens, per lens |
148 |
74 |
$0.00 |