| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,262 |
4,257 |
$73K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,120 |
3,120 |
$72K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,239 |
2,238 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,267 |
3,264 |
$46K |
| 92015 |
Determination of refractive state |
5,421 |
5,420 |
$25K |
| 92341 |
|
788 |
786 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
32 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
65 |
57 |
$122.74 |
| 92250 |
|
40 |
40 |
$90.56 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
47 |
47 |
$0.00 |