| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76512 |
|
985 |
973 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,795 |
4,747 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
673 |
673 |
$309.62 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
506 |
502 |
$193.22 |
| 92226 |
|
75 |
75 |
$40.37 |
| 92202 |
|
98 |
98 |
$16.97 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,435 |
1,432 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
178 |
177 |
$0.00 |
| 1036F |
|
55 |
55 |
$0.00 |
| V2020 |
Frames, purchases |
3,032 |
3,017 |
$0.00 |
| 68761 |
|
764 |
747 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,189 |
1,185 |
$0.00 |