| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,343 |
899 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
571 |
240 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
763 |
423 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
549 |
247 |
$20K |
| 92015 |
Determination of refractive state |
1,616 |
637 |
$15K |
| V2020 |
Frames, purchases |
781 |
733 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
519 |
495 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
58 |
55 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$562.80 |