| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
738 |
717 |
$73K |
| V2020 |
Frames, purchases |
1,821 |
1,079 |
$62K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
715 |
417 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
951 |
583 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,805 |
1,068 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,905 |
1,117 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
181 |
171 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
116 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
74 |
71 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
82 |
52 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
20 |
13 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$716.06 |
| 92015 |
Determination of refractive state |
1,634 |
1,576 |
$506.56 |