| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,144 |
3,144 |
$334K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,651 |
1,651 |
$212K |
| 92015 |
Determination of refractive state |
5,100 |
5,082 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,528 |
1,527 |
$46K |
| V2020 |
Frames, purchases |
3,897 |
3,891 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,414 |
1,409 |
$36K |
| 92250 |
|
1,157 |
1,157 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,850 |
1,846 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
27 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$834.56 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$0.00 |