| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
437 |
437 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
427 |
427 |
$47K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
623 |
618 |
$19K |
| 92015 |
Determination of refractive state |
1,057 |
1,057 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
478 |
475 |
$12K |
| V2020 |
Frames, purchases |
630 |
625 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
409 |
407 |
$0.00 |