| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,330 |
3,330 |
$335K |
| 92015 |
Determination of refractive state |
5,203 |
5,203 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,493 |
2,491 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
533 |
533 |
$64K |
| V2020 |
Frames, purchases |
3,621 |
3,619 |
$35K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
219 |
219 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
51 |
39 |
$5K |
| 92341 |
|
131 |
131 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
121 |
121 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
89 |
89 |
$2K |
| 92083 |
|
28 |
28 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
13 |
$997.93 |
| 92250 |
|
25 |
25 |
$687.19 |