| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
614 |
614 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
226 |
226 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
925 |
924 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
921 |
919 |
$26K |
| 92015 |
Determination of refractive state |
1,213 |
1,213 |
$21K |
| V2020 |
Frames, purchases |
946 |
945 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$885.78 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
965 |
963 |
$0.00 |