| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92083 |
|
1,432 |
1,426 |
$81K |
| 92250 |
|
1,430 |
1,424 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,408 |
1,378 |
$74K |
| 92060 |
|
1,327 |
1,320 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
627 |
624 |
$39K |
| 76512 |
|
304 |
154 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
592 |
584 |
$14K |
| V2020 |
Frames, purchases |
684 |
675 |
$14K |
| 68761 |
|
40 |
19 |
$3K |
| 68810 |
|
28 |
14 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
210 |
207 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
18 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
16 |
16 |
$450.00 |
| 92015 |
Determination of refractive state |
16 |
16 |
$0.00 |