| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
853 |
817 |
$41K |
| 92083 |
|
696 |
663 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
695 |
644 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
526 |
521 |
$13K |
| V2020 |
Frames, purchases |
620 |
615 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
273 |
269 |
$11K |
| 68761 |
|
13 |
13 |
$1K |
| 92133 |
|
32 |
30 |
$721.91 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$416.30 |
| 92202 |
|
15 |
14 |
$138.09 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$48.00 |