| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,339 |
1,304 |
$86K |
| 92250 |
|
1,363 |
1,344 |
$61K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,168 |
1,213 |
$37K |
| 92285 |
|
1,229 |
1,218 |
$33K |
| 76512 |
|
396 |
389 |
$27K |
| V2020 |
Frames, purchases |
2,328 |
2,317 |
$25K |
| 92082 |
|
396 |
395 |
$18K |
| 92083 |
|
227 |
225 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
190 |
186 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
347 |
346 |
$4K |
| 92286 |
|
46 |
43 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
227 |
200 |
$2K |
| 92002 |
|
53 |
53 |
$1K |
| 92025 |
|
27 |
27 |
$598.32 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$473.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
16 |
$356.30 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
256 |
142 |
$168.00 |