| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
4,417 |
3,856 |
$135K |
| 92250 |
|
2,378 |
2,127 |
$79K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,337 |
1,188 |
$71K |
| 92285 |
|
1,987 |
1,783 |
$37K |
| 92002 |
|
981 |
879 |
$30K |
| 92082 |
|
1,018 |
918 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
500 |
445 |
$19K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
596 |
554 |
$18K |
| V2020 |
Frames, purchases |
661 |
617 |
$18K |
| 92081 |
|
709 |
636 |
$17K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
247 |
236 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
302 |
284 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
99 |
94 |
$3K |
| 92341 |
|
86 |
79 |
$2K |
| 92083 |
|
18 |
18 |
$732.19 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
18 |
18 |
$694.09 |