| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
589 |
555 |
$26K |
| 92083 |
|
572 |
541 |
$24K |
| V2020 |
Frames, purchases |
239 |
212 |
$18K |
| 92134 |
|
291 |
285 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
230 |
219 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
134 |
131 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
126 |
110 |
$4K |
| 92015 |
Determination of refractive state |
943 |
657 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
69 |
63 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
12 |
$681.60 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
12 |
$660.79 |
| 92225 |
|
15 |
15 |
$296.34 |
| V2750 |
Anti-reflective coating, per lens |
51 |
41 |
$10.98 |
| V2025 |
Deluxe frame |
65 |
65 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
40 |
40 |
$0.00 |