| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,082 |
1,036 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,733 |
1,710 |
$37K |
| V2020 |
Frames, purchases |
1,984 |
1,966 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
535 |
486 |
$24K |
| 92015 |
Determination of refractive state |
798 |
789 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
209 |
209 |
$13K |
| 92341 |
|
245 |
245 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
95 |
95 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
41 |
40 |
$925.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
42 |
41 |
$824.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$580.00 |