| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
615 |
604 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
126 |
123 |
$4K |
| 92015 |
Determination of refractive state |
391 |
384 |
$783.20 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
54 |
54 |
$780.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
68 |
68 |
$525.80 |
| V2020 |
Frames, purchases |
174 |
173 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
62 |
37 |
$0.00 |
| 2023F |
|
41 |
41 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
96 |
55 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
33 |
$0.00 |
| 1036F |
|
26 |
25 |
$0.00 |