| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,737 |
4,621 |
$98K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,215 |
2,157 |
$95K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,031 |
1,968 |
$92K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,079 |
1,021 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,346 |
1,268 |
$47K |
| 92341 |
|
1,501 |
1,445 |
$37K |
| 92015 |
Determination of refractive state |
4,524 |
4,360 |
$32K |
| 92250 |
|
209 |
200 |
$5K |
| V2020 |
Frames, purchases |
100 |
100 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
73 |
73 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
26 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$968.77 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
18 |
18 |
$640.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17 |
17 |
$208.00 |
| 3072F |
|
1,020 |
992 |
$0.00 |
| 1036F |
|
29 |
29 |
$0.00 |
| 2026F |
|
21 |
20 |
$0.00 |