| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,126 |
5,748 |
$684K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,846 |
5,545 |
$563K |
| V2523 |
Contact lens, hydrophilic, extended wear, per lens |
163 |
148 |
$22K |
| 92015 |
Determination of refractive state |
11,897 |
11,179 |
$6K |
| 92310 |
|
81 |
78 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
19 |
15 |
$1K |
| 92250 |
|
12 |
12 |
$141.00 |