| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
9,805 |
9,535 |
$208K |
| 92015 |
Determination of refractive state |
7,447 |
7,189 |
$132K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,240 |
5,984 |
$130K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
6,376 |
6,182 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,153 |
2,053 |
$60K |
| 92273 |
|
1,538 |
1,526 |
$54K |
| 92341 |
|
1,159 |
1,135 |
$33K |
| 92083 |
|
1,280 |
1,187 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
460 |
431 |
$13K |
| 92133 |
|
426 |
327 |
$6K |
| 92134 |
|
520 |
430 |
$5K |
| 92002 |
|
178 |
177 |
$2K |
| V2020 |
Frames, purchases |
134 |
132 |
$2K |
| 65778 |
|
13 |
13 |
$523.26 |
| 92285 |
|
65 |
55 |
$434.69 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
13 |
$335.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
15 |
$54.26 |