| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76512 |
|
2,582 |
1,305 |
$172K |
| 92250 |
|
2,819 |
2,799 |
$128K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,822 |
2,802 |
$105K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,303 |
2,093 |
$65K |
| 92083 |
|
1,276 |
1,272 |
$59K |
| 92285 |
|
1,882 |
1,873 |
$48K |
| V2020 |
Frames, purchases |
3,858 |
3,778 |
$47K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
886 |
438 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
207 |
207 |
$10K |
| 68761 |
|
76 |
38 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
766 |
383 |
$6K |
| 92225 |
|
331 |
164 |
$4K |
| 76514 |
|
379 |
377 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
49 |
49 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
72 |
72 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
74 |
37 |
$457.28 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
912 |
442 |
$0.00 |
| V2755 |
U-v lens, per lens |
1,622 |
791 |
$0.00 |