| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,439 |
1,358 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
610 |
583 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
656 |
203 |
$18K |
| V2020 |
Frames, purchases |
505 |
349 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
612 |
543 |
$9K |
| 92250 |
|
281 |
268 |
$7K |
| 92083 |
|
95 |
95 |
$4K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
17 |
12 |
$3K |
| 92133 |
|
97 |
96 |
$2K |
| 92020 |
|
137 |
130 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
518 |
157 |
$870.00 |
| 92235 |
|
55 |
52 |
$868.22 |
| 92134 |
|
12 |
12 |
$343.96 |