| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
1,827 |
1,799 |
$70K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,360 |
2,271 |
$23K |
| 92002 |
|
711 |
707 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
25 |
$611.00 |
| V2020 |
Frames, purchases |
1,622 |
1,603 |
$520.00 |
| 92201 |
|
40 |
40 |
$376.46 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,505 |
1,353 |
$252.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$200.00 |
| 92015 |
Determination of refractive state |
66 |
66 |
$193.60 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
18 |
18 |
$55.60 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,614 |
866 |
$34.20 |
| V2750 |
Anti-reflective coating, per lens |
936 |
496 |
$0.00 |
| V2781 |
Progressive lens, per lens |
21 |
12 |
$0.00 |
| V2299 |
Specialty bifocal (by report) |
23 |
13 |
$0.00 |