| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
866 |
864 |
$66K |
| 92250 |
|
1,370 |
1,363 |
$65K |
| 76512 |
|
985 |
567 |
$60K |
| 92083 |
|
1,141 |
1,108 |
$59K |
| 92285 |
|
1,401 |
1,378 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
400 |
400 |
$26K |
| 92060 |
|
576 |
568 |
$21K |
| 92225 |
|
352 |
172 |
$5K |
| V2020 |
Frames, purchases |
798 |
797 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
260 |
130 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
140 |
72 |
$821.60 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
13 |
$228.64 |
| V2755 |
U-v lens, per lens |
44 |
22 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
32 |
16 |
$0.00 |