| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,591 |
1,582 |
$133K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,704 |
1,684 |
$120K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,300 |
2,261 |
$46K |
| 92015 |
Determination of refractive state |
3,598 |
3,484 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
495 |
471 |
$18K |
| V2020 |
Frames, purchases |
259 |
245 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
108 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
124 |
123 |
$2K |
| V2756 |
Eye glass case |
58 |
58 |
$960.38 |
| V2755 |
U-v lens, per lens |
90 |
90 |
$862.20 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$591.40 |
| V2106 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens |
12 |
12 |
$141.12 |