| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,543 |
2,477 |
$160K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,244 |
1,216 |
$110K |
| V2020 |
Frames, purchases |
3,574 |
3,388 |
$82K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,938 |
1,855 |
$47K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
407 |
393 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
522 |
493 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
83 |
65 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
15 |
$443.28 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
79 |
75 |
$427.28 |
| 92015 |
Determination of refractive state |
3,974 |
3,885 |
$45.15 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$0.00 |