| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
8,377 |
8,314 |
$130K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
1,470 |
1,467 |
$91K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,436 |
1,428 |
$81K |
| V2025 |
Deluxe frame |
1,472 |
1,469 |
$49K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
73 |
53 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
26 |
19 |
$844.52 |
| V2207 |
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens |
15 |
15 |
$803.66 |
| 92275 |
|
27 |
17 |
$694.60 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
40 |
22 |
$532.98 |
| 92250 |
|
40 |
25 |
$481.63 |
| 92020 |
|
35 |
23 |
$121.77 |