| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,106 |
1,068 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
781 |
766 |
$68K |
| V2020 |
Frames, purchases |
1,085 |
1,018 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
619 |
576 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
277 |
277 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
79 |
68 |
$840.48 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$521.62 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$221.95 |
| 92015 |
Determination of refractive state |
2,003 |
1,835 |
$0.00 |