| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,090 |
1,090 |
$118K |
| 92015 |
Determination of refractive state |
1,824 |
1,824 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,029 |
1,029 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
111 |
111 |
$14K |
| V2020 |
Frames, purchases |
1,250 |
1,249 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
352 |
352 |
$10K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
245 |
245 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
78 |
77 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,212 |
1,212 |
$0.00 |