| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
268 |
268 |
$12K |
| 92015 |
Determination of refractive state |
383 |
383 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
346 |
344 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
56 |
56 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
23 |
20 |
$978.24 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
36 |
36 |
$576.00 |
| V2020 |
Frames, purchases |
419 |
417 |
$520.00 |
| 92341 |
|
14 |
14 |
$377.58 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
437 |
434 |
$150.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
237 |
235 |
$0.00 |