| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
944 |
933 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
542 |
534 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
106 |
103 |
$2K |
| V2020 |
Frames, purchases |
137 |
133 |
$2K |
| 92250 |
|
129 |
125 |
$2K |
| 92083 |
|
69 |
68 |
$1K |
| 92020 |
|
102 |
99 |
$714.42 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
73 |
72 |
$710.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
29 |
24 |
$359.67 |
| 92015 |
Determination of refractive state |
178 |
177 |
$139.39 |
| 92134 |
|
16 |
15 |
$132.31 |