| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76512 |
|
3,372 |
1,687 |
$202K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,142 |
2,138 |
$148K |
| 92250 |
|
3,020 |
3,012 |
$131K |
| 92083 |
|
2,250 |
2,245 |
$105K |
| 92285 |
|
2,843 |
2,831 |
$74K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
794 |
793 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,276 |
1,329 |
$41K |
| V2020 |
Frames, purchases |
2,248 |
2,218 |
$29K |
| 68801 |
|
154 |
76 |
$8K |
| 92286 |
|
214 |
213 |
$5K |
| 92060 |
|
113 |
113 |
$4K |
| 76514 |
|
211 |
211 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
41 |
27 |
$723.96 |
| 92015 |
Determination of refractive state |
24 |
24 |
$532.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
24 |
24 |
$360.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
15 |
$287.56 |
| 92025 |
|
30 |
30 |
$128.99 |