| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
367 |
367 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
206 |
206 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
694 |
694 |
$21K |
| 92015 |
Determination of refractive state |
716 |
716 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
479 |
478 |
$12K |
| V2020 |
Frames, purchases |
729 |
729 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
107 |
107 |
$4K |
| 92250 |
|
142 |
142 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
731 |
731 |
$0.00 |