| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
15,964 |
15,764 |
$232K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,458 |
5,229 |
$224K |
| V2020 |
Frames, purchases |
9,139 |
8,744 |
$217K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,660 |
9,510 |
$210K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,473 |
4,407 |
$145K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
9,996 |
9,851 |
$145K |
| 92250 |
|
10,929 |
10,286 |
$134K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,237 |
2,145 |
$99K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,069 |
1,010 |
$41K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
928 |
895 |
$38K |
| 92273 |
|
1,771 |
1,688 |
$23K |
| V2750 |
Anti-reflective coating, per lens |
786 |
698 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
508 |
488 |
$13K |
| 92020 |
|
545 |
542 |
$2K |
| 76512 |
|
91 |
90 |
$2K |
| 76514 |
|
736 |
727 |
$1K |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
13 |
12 |
$571.06 |
| 68761 |
|
13 |
13 |
$382.56 |
| 67820 |
|
27 |
27 |
$375.59 |
| 92285 |
|
49 |
49 |
$207.99 |