| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
576 |
566 |
$17K |
| 92083 |
|
473 |
466 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
331 |
301 |
$5K |
| 92020 |
|
415 |
408 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,459 |
1,426 |
$3K |
| 92225 |
|
116 |
57 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
751 |
345 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
72 |
72 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
62 |
24 |
$0.00 |
| 92283 |
|
12 |
12 |
$0.00 |
| 92273 |
|
21 |
19 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
226 |
113 |
$0.00 |
| V2020 |
Frames, purchases |
732 |
691 |
$0.00 |