| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,594 |
1,578 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
180 |
180 |
$8K |
| 92015 |
Determination of refractive state |
327 |
327 |
$6K |
| 92341 |
|
112 |
112 |
$3K |
| V2020 |
Frames, purchases |
2,005 |
1,984 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
28 |
$1K |
| 92083 |
|
24 |
24 |
$646.80 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$566.93 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
297 |
295 |
$497.60 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,887 |
1,865 |
$91.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
16 |
$75.40 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
925 |
917 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
37 |
37 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
48 |
48 |
$0.00 |