| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
408 |
408 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
678 |
671 |
$15K |
| 92015 |
Determination of refractive state |
658 |
658 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
234 |
234 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
134 |
131 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55 |
53 |
$2K |
| 92341 |
|
43 |
43 |
$1K |
| V2020 |
Frames, purchases |
730 |
722 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
774 |
767 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
436 |
432 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
119 |
118 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$0.00 |