| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,096 |
3,095 |
$214K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,848 |
1,846 |
$163K |
| V2020 |
Frames, purchases |
4,384 |
4,360 |
$125K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,291 |
2,284 |
$86K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,176 |
1,175 |
$43K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
826 |
825 |
$20K |
| 92015 |
Determination of refractive state |
4,224 |
4,221 |
$17K |
| 92225 |
|
292 |
287 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,108 |
1,107 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,441 |
1,440 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
132 |
106 |
$5K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
111 |
110 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$258.72 |