| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,326 |
1,300 |
$69K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
785 |
766 |
$52K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,139 |
1,053 |
$43K |
| 92250 |
|
504 |
491 |
$21K |
| V2020 |
Frames, purchases |
1,735 |
1,695 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
148 |
72 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21 |
21 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,511 |
1,701 |
$920.00 |