| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,958 |
1,957 |
$97K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,336 |
2,329 |
$88K |
| 92015 |
Determination of refractive state |
4,514 |
4,507 |
$30K |
| V2020 |
Frames, purchases |
1,670 |
1,666 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
440 |
437 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
85 |
85 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$220.54 |