| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
179 |
173 |
$18K |
| 92250 |
|
273 |
268 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
827 |
797 |
$15K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
155 |
154 |
$12K |
| V2025 |
Deluxe frame |
290 |
290 |
$12K |
| V2020 |
Frames, purchases |
617 |
590 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
131 |
131 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
493 |
473 |
$9K |
| 92015 |
Determination of refractive state |
351 |
345 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
61 |
59 |
$792.04 |