| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,231 |
2,230 |
$260K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,195 |
1,195 |
$166K |
| V2020 |
Frames, purchases |
3,182 |
3,159 |
$121K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,996 |
2,951 |
$88K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
727 |
722 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
633 |
621 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
196 |
196 |
$5K |
| 92133 |
|
76 |
76 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
15 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$1K |
| 92083 |
|
13 |
12 |
$851.76 |