| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,147 |
1,143 |
$83K |
| 76512 |
|
835 |
450 |
$55K |
| 92083 |
|
969 |
968 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,342 |
1,300 |
$43K |
| V2020 |
Frames, purchases |
1,721 |
1,712 |
$31K |
| 92250 |
|
461 |
459 |
$21K |
| 92285 |
|
672 |
672 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
136 |
136 |
$8K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
102 |
50 |
$3K |
| 92020 |
|
58 |
58 |
$780.52 |
| 76514 |
|
70 |
70 |
$559.30 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
520 |
257 |
$0.00 |
| V2755 |
U-v lens, per lens |
62 |
31 |
$0.00 |