| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
294 |
294 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
394 |
394 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
79 |
79 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
311 |
311 |
$8K |
| 92015 |
Determination of refractive state |
426 |
426 |
$7K |
| V2020 |
Frames, purchases |
385 |
385 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
27 |
$530.10 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
13 |
$432.34 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
408 |
408 |
$0.00 |