| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76512 |
|
970 |
488 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,689 |
1,556 |
$56K |
| 92250 |
|
1,172 |
1,166 |
$52K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,733 |
1,511 |
$46K |
| V2020 |
Frames, purchases |
2,456 |
2,414 |
$33K |
| 92285 |
|
1,021 |
1,017 |
$28K |
| 92083 |
|
649 |
644 |
$28K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
362 |
212 |
$9K |
| 68761 |
|
122 |
60 |
$9K |
| 92002 |
|
60 |
60 |
$2K |
| 92081 |
|
48 |
48 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
122 |
61 |
$451.88 |
| 76514 |
|
42 |
42 |
$327.59 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
390 |
192 |
$50.00 |
| V2755 |
U-v lens, per lens |
728 |
364 |
$0.00 |