| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,017 |
1,439 |
$282K |
| 92060 |
|
4,289 |
1,633 |
$231K |
| 92250 |
|
1,148 |
1,081 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
570 |
530 |
$52K |
| 92065 |
|
1,276 |
504 |
$48K |
| V2020 |
Frames, purchases |
664 |
554 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
291 |
281 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
491 |
402 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
634 |
519 |
$22K |
| V2750 |
Anti-reflective coating, per lens |
83 |
62 |
$2K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
39 |
29 |
$2K |
| 92015 |
Determination of refractive state |
1,556 |
1,435 |
$725.75 |