| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,346 |
3,338 |
$237K |
| 76512 |
|
3,085 |
1,802 |
$197K |
| 92250 |
|
3,659 |
3,653 |
$162K |
| 92083 |
|
3,266 |
3,262 |
$156K |
| 92285 |
|
3,583 |
3,572 |
$84K |
| 92060 |
|
2,077 |
2,072 |
$76K |
| V2020 |
Frames, purchases |
2,745 |
2,735 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,300 |
1,223 |
$44K |
| 92286 |
|
389 |
388 |
$30K |
| 92020 |
|
1,252 |
1,250 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
367 |
364 |
$14K |
| 92015 |
Determination of refractive state |
899 |
899 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
386 |
200 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
663 |
663 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
638 |
585 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
80 |
$5K |
| 76514 |
|
594 |
594 |
$5K |
| 92133 |
|
132 |
132 |
$4K |
| 92025 |
|
39 |
39 |
$864.24 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
27 |
27 |
$486.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$262.05 |
| 92341 |
|
16 |
16 |
$257.25 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
178 |
89 |
$0.00 |