| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,139 |
1,132 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,989 |
1,937 |
$42K |
| 92015 |
Determination of refractive state |
1,844 |
1,833 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
292 |
291 |
$14K |
| 92341 |
|
79 |
77 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$864.42 |
| V2020 |
Frames, purchases |
2,090 |
2,039 |
$360.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
135 |
130 |
$336.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,728 |
1,694 |
$78.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,367 |
1,338 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
24 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$0.00 |