| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,351 |
3,293 |
$214K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,627 |
1,589 |
$124K |
| 92015 |
Determination of refractive state |
6,465 |
6,348 |
$68K |
| V2020 |
Frames, purchases |
2,432 |
2,340 |
$58K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,089 |
2,022 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,051 |
897 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
355 |
288 |
$11K |
| 92341 |
|
462 |
452 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,065 |
1,013 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
67 |
56 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
83 |
78 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$720.48 |