| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,425 |
1,403 |
$86K |
| 92083 |
|
1,405 |
1,404 |
$62K |
| 92250 |
|
1,418 |
1,417 |
$62K |
| 76512 |
|
750 |
374 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
419 |
419 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
878 |
468 |
$18K |
| V2020 |
Frames, purchases |
681 |
648 |
$9K |
| 68761 |
|
38 |
15 |
$2K |
| 92060 |
|
334 |
327 |
$740.46 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
916 |
438 |
$712.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
18 |
12 |
$320.00 |