| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
3,239 |
2,997 |
$170K |
| V2025 |
Deluxe frame |
3,373 |
3,268 |
$160K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
3,391 |
3,300 |
$143K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,736 |
4,408 |
$138K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,301 |
1,243 |
$127K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,637 |
5,367 |
$95K |
| V2020 |
Frames, purchases |
5,861 |
5,646 |
$84K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,426 |
2,336 |
$38K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,394 |
1,288 |
$25K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
473 |
460 |
$20K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
451 |
429 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
73 |
$6K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
199 |
187 |
$5K |
| 92002 |
|
34 |
27 |
$1K |
| 92015 |
Determination of refractive state |
30 |
30 |
$467.44 |