| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
1,303 |
855 |
$37K |
| 92083 |
|
684 |
584 |
$34K |
| 92250 |
|
923 |
781 |
$32K |
| V2020 |
Frames, purchases |
301 |
196 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
317 |
96 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
95 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
109 |
38 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
268 |
80 |
$585.00 |
| 92020 |
|
12 |
12 |
$230.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
177 |
128 |
$35.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
131 |
$0.00 |
| 2023F |
|
40 |
27 |
$0.00 |