| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,854 |
2,853 |
$288K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,304 |
1,304 |
$157K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,090 |
3,076 |
$92K |
| 92015 |
Determination of refractive state |
3,855 |
3,854 |
$68K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,169 |
2,162 |
$51K |
| V2020 |
Frames, purchases |
3,349 |
3,341 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,089 |
1,087 |
$24K |
| V2025 |
Deluxe frame |
13 |
13 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
49 |
48 |
$498.58 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,390 |
3,381 |
$0.00 |