| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,526 |
2,501 |
$188K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,501 |
2,443 |
$55K |
| V2020 |
Frames, purchases |
1,779 |
1,741 |
$44K |
| 92015 |
Determination of refractive state |
3,767 |
3,724 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
365 |
359 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,489 |
936 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,043 |
2,003 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$912.79 |
| 92341 |
|
25 |
25 |
$697.75 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22 |
16 |
$396.22 |