| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,521 |
3,381 |
$224K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,973 |
1,893 |
$172K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,420 |
2,332 |
$156K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
832 |
805 |
$37K |
| 92341 |
|
383 |
365 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
314 |
300 |
$12K |
| 92002 |
|
222 |
215 |
$11K |
| 92015 |
Determination of refractive state |
825 |
769 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
68 |
65 |
$5K |
| 92370 |
|
150 |
150 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
178 |
136 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$665.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
34 |
34 |
$0.00 |
| 1036F |
|
29 |
28 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |
| V2020 |
Frames, purchases |
77 |
77 |
$0.00 |
| 4004F |
|
44 |
43 |
$0.00 |