| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
110 |
102 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
92 |
80 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
212 |
98 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
246 |
246 |
$0.00 |
| V2020 |
Frames, purchases |
585 |
548 |
$0.00 |
| 92015 |
Determination of refractive state |
327 |
326 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,219 |
577 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,130 |
527 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
183 |
182 |
$0.00 |