| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,049 |
3,048 |
$106K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,541 |
3,416 |
$69K |
| V2020 |
Frames, purchases |
3,256 |
3,139 |
$62K |
| 92015 |
Determination of refractive state |
3,539 |
3,536 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
480 |
478 |
$17K |
| 92341 |
|
257 |
255 |
$7K |
| 92250 |
|
145 |
145 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
90 |
82 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
66 |
56 |
$677.82 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$168.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
40 |
40 |
$140.00 |