| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,413 |
2,144 |
$353K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,383 |
1,214 |
$143K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
640 |
572 |
$105K |
| 92060 |
|
4,576 |
4,076 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,498 |
1,325 |
$27K |
| 92015 |
Determination of refractive state |
2,430 |
2,198 |
$11K |
| V2020 |
Frames, purchases |
1,084 |
961 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,583 |
1,406 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,089 |
615 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
122 |
63 |
$82.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
61 |
29 |
$60.00 |