| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
3,405 |
3,377 |
$152K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,086 |
2,080 |
$125K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,955 |
1,943 |
$104K |
| 92285 |
|
2,569 |
2,555 |
$82K |
| V2020 |
Frames, purchases |
4,116 |
4,056 |
$70K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,501 |
1,595 |
$39K |
| 76512 |
|
459 |
398 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,180 |
739 |
$18K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
337 |
220 |
$7K |
| 92083 |
|
78 |
78 |
$4K |
| 92286 |
|
54 |
54 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,118 |
699 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
63 |
63 |
$2K |
| 92020 |
|
352 |
350 |
$1K |
| 92133 |
|
45 |
45 |
$1K |
| 76514 |
|
58 |
58 |
$422.20 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$378.78 |
| 92025 |
|
26 |
26 |
$329.96 |
| 92225 |
|
15 |
15 |
$225.92 |
| V2755 |
U-v lens, per lens |
162 |
81 |
$0.00 |
| 2023F |
|
44 |
44 |
$0.00 |