| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,369 |
2,363 |
$210K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,439 |
2,436 |
$192K |
| 68761 |
|
1,286 |
646 |
$95K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,721 |
1,655 |
$79K |
| 92250 |
|
1,288 |
1,285 |
$46K |
| 92134 |
|
827 |
827 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
981 |
546 |
$20K |
| 92083 |
|
430 |
429 |
$18K |
| V2020 |
Frames, purchases |
722 |
717 |
$10K |
| 92133 |
|
387 |
386 |
$10K |
| 92020 |
|
433 |
432 |
$7K |
| 92015 |
Determination of refractive state |
462 |
461 |
$5K |
| 92060 |
|
108 |
108 |
$4K |
| 92202 |
|
183 |
181 |
$2K |
| 92285 |
|
70 |
69 |
$1K |
| 76514 |
|
182 |
182 |
$1K |
| E0700 |
Safety equipment, device or accessory, any type |
173 |
161 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
630 |
336 |
$708.00 |
| 92201 |
|
14 |
14 |
$258.20 |