| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,694 |
1,684 |
$91K |
| 92285 |
|
1,265 |
1,252 |
$76K |
| 92250 |
|
1,143 |
1,137 |
$52K |
| 92083 |
|
983 |
971 |
$44K |
| V2020 |
Frames, purchases |
1,554 |
1,543 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
721 |
719 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
145 |
144 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
97 |
96 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$459.30 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$98.00 |