| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92060 |
|
2,331 |
1,877 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,560 |
1,417 |
$83K |
| 92015 |
Determination of refractive state |
3,285 |
2,707 |
$67K |
| V2020 |
Frames, purchases |
891 |
810 |
$63K |
| 92002 |
|
714 |
479 |
$49K |
| 92250 |
|
1,535 |
1,226 |
$42K |
| 92283 |
|
1,851 |
1,687 |
$39K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
393 |
259 |
$29K |
| 92083 |
|
990 |
897 |
$20K |
| 92081 |
|
758 |
477 |
$20K |
| 92020 |
|
850 |
738 |
$14K |
| 92225 |
|
536 |
471 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
646 |
301 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
14 |
$490.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
762 |
357 |
$244.72 |
| 92201 |
|
49 |
49 |
$0.00 |