| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,472 |
3,443 |
$253K |
| 92250 |
|
2,799 |
2,739 |
$123K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,476 |
3,042 |
$95K |
| V2020 |
Frames, purchases |
4,121 |
4,068 |
$70K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,161 |
1,152 |
$65K |
| 68761 |
|
839 |
423 |
$65K |
| 92083 |
|
1,081 |
1,065 |
$50K |
| 92285 |
|
1,040 |
1,028 |
$29K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,093 |
646 |
$24K |
| 76512 |
|
230 |
114 |
$15K |
| 92060 |
|
432 |
417 |
$15K |
| 92202 |
|
350 |
344 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
26 |
25 |
$1K |
| 76514 |
|
18 |
13 |
$107.96 |