| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,849 |
1,801 |
$82K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
1,739 |
1,672 |
$77K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
924 |
915 |
$70K |
| V2020 |
Frames, purchases |
3,146 |
3,019 |
$62K |
| 92081 |
|
2,046 |
1,994 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,165 |
2,098 |
$36K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
825 |
804 |
$36K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,853 |
1,779 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
253 |
247 |
$24K |
| 92015 |
Determination of refractive state |
1,429 |
1,400 |
$17K |
| V2025 |
Deluxe frame |
132 |
131 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
421 |
413 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
225 |
215 |
$3K |