| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,456 |
7,456 |
$826K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,895 |
5,895 |
$777K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
10,589 |
10,543 |
$321K |
| 92015 |
Determination of refractive state |
13,504 |
13,504 |
$238K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
8,718 |
8,674 |
$215K |
| V2020 |
Frames, purchases |
10,643 |
10,598 |
$106K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,773 |
1,752 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,802 |
1,799 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
226 |
224 |
$18K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
135 |
134 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
24 |
24 |
$2K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
14 |
14 |
$265.05 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
11,096 |
11,036 |
$0.00 |