| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
2,436 |
2,233 |
$78K |
| 92015 |
Determination of refractive state |
2,496 |
2,291 |
$72K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,420 |
1,294 |
$51K |
| 92081 |
|
2,352 |
2,150 |
$51K |
| V2020 |
Frames, purchases |
779 |
733 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
285 |
252 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
525 |
498 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
305 |
169 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
123 |
96 |
$3K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
155 |
71 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
432 |
210 |
$0.00 |