| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
555 |
553 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
578 |
577 |
$37K |
| 92015 |
Determination of refractive state |
1,402 |
1,395 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
836 |
830 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
70 |
65 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
29 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$520.00 |