| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,876 |
3,839 |
$281K |
| 92250 |
|
4,398 |
4,369 |
$196K |
| 68761 |
|
2,653 |
1,307 |
$183K |
| 92083 |
|
2,504 |
2,466 |
$112K |
| 92285 |
|
3,745 |
3,724 |
$95K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,288 |
1,283 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,126 |
1,110 |
$37K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
531 |
495 |
$20K |
| V2020 |
Frames, purchases |
1,603 |
1,589 |
$17K |
| 92060 |
|
302 |
300 |
$11K |
| 92133 |
|
321 |
318 |
$9K |
| 92015 |
Determination of refractive state |
756 |
756 |
$9K |
| 92225 |
|
368 |
197 |
$5K |
| 76514 |
|
27 |
26 |
$225.31 |
| 92020 |
|
14 |
13 |
$215.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
242 |
120 |
$0.00 |