| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
748 |
747 |
$52K |
| 92060 |
|
630 |
625 |
$22K |
| 92202 |
|
255 |
254 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
195 |
108 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
73 |
73 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
67 |
62 |
$3K |
| V2020 |
Frames, purchases |
143 |
141 |
$2K |
| 92250 |
|
27 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
215 |
109 |
$13.00 |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |