| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,176 |
1,135 |
$76K |
| 92250 |
|
1,475 |
1,449 |
$63K |
| 92082 |
|
1,383 |
1,357 |
$59K |
| 68761 |
|
752 |
371 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
756 |
709 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,487 |
732 |
$25K |
| V2020 |
Frames, purchases |
1,098 |
1,065 |
$19K |
| 92285 |
|
292 |
268 |
$8K |
| 76514 |
|
508 |
491 |
$4K |
| 92083 |
|
73 |
71 |
$3K |
| 92133 |
|
53 |
53 |
$2K |
| 92202 |
|
31 |
25 |
$740.03 |
| 92020 |
|
33 |
28 |
$248.48 |
| V2755 |
U-v lens, per lens |
286 |
140 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
170 |
82 |
$0.00 |
| 92015 |
Determination of refractive state |
1,168 |
1,133 |
$0.00 |