| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,795 |
1,795 |
$196K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
638 |
638 |
$83K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,629 |
2,624 |
$79K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,823 |
2,796 |
$78K |
| 92015 |
Determination of refractive state |
2,593 |
2,590 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
302 |
275 |
$31K |
| V2020 |
Frames, purchases |
2,627 |
2,623 |
$26K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
67 |
67 |
$9K |
| 92250 |
|
154 |
154 |
$4K |