| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,645 |
2,592 |
$56K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
562 |
550 |
$37K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
692 |
691 |
$31K |
| 92015 |
Determination of refractive state |
1,085 |
1,084 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
285 |
285 |
$14K |
| 92341 |
|
285 |
271 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$523.32 |
| 92133 |
|
14 |
14 |
$223.44 |
| V2020 |
Frames, purchases |
2,860 |
2,800 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
134 |
130 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
27 |
26 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,654 |
1,624 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,952 |
2,889 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
458 |
456 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$0.00 |
| V2781 |
Progressive lens, per lens |
13 |
13 |
$0.00 |