| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
777 |
755 |
$7K |
| 92015 |
Determination of refractive state |
603 |
592 |
$4K |
| 92083 |
|
102 |
101 |
$2K |
| 92134 |
|
135 |
119 |
$2K |
| 68761 |
|
30 |
29 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
74 |
62 |
$1K |
| 92133 |
|
73 |
73 |
$1K |
| 92202 |
|
313 |
288 |
$585.57 |
| 92020 |
|
42 |
40 |
$571.27 |
| 92286 |
|
46 |
43 |
$450.00 |
| 92250 |
|
15 |
14 |
$404.69 |
| 92145 |
|
33 |
32 |
$163.03 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
89 |
88 |
$158.00 |
| V2020 |
Frames, purchases |
1,553 |
1,545 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
177 |
103 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
168 |
98 |
$0.00 |
| V2781 |
Progressive lens, per lens |
21 |
12 |
$0.00 |