| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,867 |
1,846 |
$127K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,217 |
1,204 |
$112K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,603 |
1,591 |
$95K |
| 92015 |
Determination of refractive state |
1,268 |
1,256 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
221 |
195 |
$8K |
| 92133 |
|
25 |
25 |
$962.57 |
| V2020 |
Frames, purchases |
369 |
368 |
$551.25 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$147.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
143 |
143 |
$130.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
77 |
77 |
$0.00 |