| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
614 |
614 |
$62K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
211 |
211 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
536 |
534 |
$16K |
| 92015 |
Determination of refractive state |
905 |
904 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
311 |
310 |
$7K |
| V2020 |
Frames, purchases |
675 |
672 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
186 |
185 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$543.65 |
| 92370 |
|
12 |
12 |
$328.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
677 |
674 |
$0.00 |