| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,218 |
1,192 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
451 |
442 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
192 |
192 |
$9K |
| 92015 |
Determination of refractive state |
1,324 |
1,308 |
$8K |
| V2020 |
Frames, purchases |
171 |
170 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
13 |
$935.98 |
| 92341 |
|
33 |
33 |
$906.92 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
29 |
29 |
$475.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
34 |
34 |
$300.00 |