| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
768 |
766 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
224 |
223 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
244 |
234 |
$8K |
| 92285 |
|
124 |
120 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
137 |
137 |
$6K |
| 92083 |
|
84 |
84 |
$4K |
| V2020 |
Frames, purchases |
53 |
51 |
$864.60 |
| 92133 |
|
16 |
16 |
$480.67 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$282.50 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
13 |
13 |
$136.50 |
| 92202 |
|
12 |
12 |
$105.13 |