| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
580 |
425 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
531 |
498 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
457 |
421 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
330 |
230 |
$19K |
| 92015 |
Determination of refractive state |
933 |
841 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
343 |
309 |
$9K |
| V2025 |
Deluxe frame |
404 |
302 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70 |
57 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
163 |
140 |
$3K |
| V2020 |
Frames, purchases |
181 |
168 |
$1K |
| 92250 |
|
26 |
26 |
$807.71 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
58 |
39 |
$374.20 |