| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,073 |
1,060 |
$45K |
| 92250 |
|
785 |
769 |
$38K |
| 92286 |
|
504 |
497 |
$37K |
| 92083 |
|
657 |
643 |
$34K |
| 76512 |
|
636 |
319 |
$31K |
| 92285 |
|
766 |
751 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
612 |
600 |
$23K |
| V2020 |
Frames, purchases |
1,521 |
1,470 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
491 |
440 |
$9K |
| 92060 |
|
146 |
131 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
255 |
254 |
$4K |
| 76514 |
|
356 |
354 |
$3K |
| 92025 |
|
103 |
102 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
194 |
136 |
$2K |
| 92015 |
Determination of refractive state |
66 |
66 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
178 |
117 |
$610.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
34 |
24 |
$517.68 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$276.00 |
| 92341 |
|
17 |
14 |
$260.00 |
| 92020 |
|
24 |
16 |
$210.14 |
| V2715 |
Prism, per lens |
15 |
12 |
$24.00 |