| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,271 |
2,190 |
$286K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
782 |
755 |
$124K |
| V2020 |
Frames, purchases |
1,534 |
1,502 |
$107K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,239 |
1,216 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
584 |
578 |
$10K |
| 92015 |
Determination of refractive state |
3,413 |
3,326 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
129 |
129 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
24 |
$1K |