| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,511 |
4,496 |
$449K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
5,424 |
5,170 |
$374K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,087 |
3,083 |
$374K |
| 92250 |
|
7,285 |
7,267 |
$293K |
| 68761 |
|
1,632 |
915 |
$137K |
| V2020 |
Frames, purchases |
2,172 |
2,167 |
$102K |
| 92082 |
|
1,618 |
1,615 |
$65K |
| 92083 |
|
1,120 |
1,111 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,006 |
1,995 |
$57K |
| 92002 |
|
616 |
616 |
$41K |
| 67700 |
|
237 |
120 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
741 |
737 |
$39K |
| 92285 |
|
3,027 |
2,987 |
$36K |
| 92015 |
Determination of refractive state |
10,847 |
10,725 |
$35K |
| 92310 |
|
459 |
399 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
467 |
465 |
$28K |
| 92133 |
|
490 |
487 |
$15K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
389 |
388 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
65 |
65 |
$4K |
| 92225 |
|
210 |
207 |
$2K |
| 92341 |
|
40 |
40 |
$1K |
| V2219 |
Bifocal seg width over 28 mm |
13 |
13 |
$1K |
| 92020 |
|
44 |
44 |
$819.23 |
| 76514 |
|
75 |
75 |
$775.76 |