| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
594 |
594 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
732 |
728 |
$22K |
| 92015 |
Determination of refractive state |
1,024 |
1,023 |
$18K |
| V2020 |
Frames, purchases |
710 |
707 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
43 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
138 |
138 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
39 |
$990.45 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
733 |
731 |
$0.00 |