| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,307 |
1,280 |
$86K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
935 |
911 |
$83K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,214 |
1,175 |
$71K |
| 92015 |
Determination of refractive state |
328 |
319 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
82 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$2K |
| V2020 |
Frames, purchases |
107 |
61 |
$849.75 |
| 92341 |
|
13 |
13 |
$744.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
15 |
$184.12 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
25 |
12 |
$69.25 |