| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,770 |
2,770 |
$277K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,745 |
3,674 |
$109K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
582 |
582 |
$73K |
| 92015 |
Determination of refractive state |
4,182 |
4,180 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,170 |
2,095 |
$49K |
| V2020 |
Frames, purchases |
3,611 |
3,553 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,271 |
1,224 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
114 |
109 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
75 |
72 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,249 |
4,120 |
$0.00 |