| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
897 |
897 |
$98K |
| 92015 |
Determination of refractive state |
1,521 |
1,520 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
870 |
870 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
140 |
140 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
586 |
586 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
379 |
379 |
$11K |
| V2020 |
Frames, purchases |
1,010 |
1,010 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$872.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
966 |
966 |
$0.00 |