| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,765 |
4,624 |
$409K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,033 |
3,007 |
$219K |
| 68761 |
|
1,642 |
822 |
$210K |
| 68040 |
|
3,383 |
1,725 |
$156K |
| 92083 |
|
1,979 |
1,969 |
$106K |
| 92250 |
|
2,249 |
2,181 |
$93K |
| 76512 |
|
1,506 |
753 |
$79K |
| 92226 |
|
1,124 |
607 |
$20K |
| 92020 |
|
796 |
795 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
170 |
168 |
$18K |
| 92060 |
|
335 |
335 |
$17K |
| 92100 |
|
255 |
254 |
$13K |
| 92133 |
|
495 |
495 |
$13K |
| 92202 |
|
934 |
914 |
$12K |
| 68801 |
|
168 |
84 |
$12K |
| 92285 |
|
407 |
407 |
$12K |
| 67820 |
|
286 |
143 |
$8K |
| 92286 |
|
214 |
214 |
$7K |
| V2020 |
Frames, purchases |
367 |
362 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
264 |
260 |
$6K |
| 92134 |
|
182 |
182 |
$5K |
| 92225 |
|
96 |
49 |
$1K |
| 92015 |
Determination of refractive state |
88 |
88 |
$1K |
| 76514 |
|
60 |
60 |
$529.25 |
| 92025 |
|
171 |
171 |
$180.30 |
| 2022F |
|
49 |
49 |
$0.00 |
| 99080 |
|
33 |
16 |
$0.00 |