| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,003 |
989 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
619 |
608 |
$42K |
| 92285 |
|
1,238 |
1,187 |
$40K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
282 |
141 |
$5K |
| V2020 |
Frames, purchases |
200 |
200 |
$2K |
| 92015 |
Determination of refractive state |
634 |
622 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
29 |
29 |
$2K |
| 92083 |
|
33 |
32 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
316 |
158 |
$0.00 |
| V2755 |
U-v lens, per lens |
24 |
12 |
$0.00 |