| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,761 |
3,537 |
$225K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,203 |
1,184 |
$92K |
| 92081 |
|
1,938 |
1,922 |
$68K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
833 |
789 |
$42K |
| 92060 |
|
722 |
721 |
$30K |
| 92250 |
|
431 |
425 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
613 |
383 |
$12K |
| 92201 |
|
636 |
630 |
$9K |
| V2020 |
Frames, purchases |
537 |
531 |
$7K |
| 76512 |
|
132 |
126 |
$5K |
| 92133 |
|
43 |
43 |
$1K |
| 92225 |
|
24 |
24 |
$573.97 |
| 92202 |
|
21 |
20 |
$381.47 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
539 |
266 |
$0.00 |