| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
565 |
503 |
$46K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
702 |
608 |
$12K |
| 92015 |
Determination of refractive state |
852 |
772 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
51 |
$6K |
| V2020 |
Frames, purchases |
38 |
38 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
30 |
$895.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21 |
12 |
$746.22 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
31 |
14 |
$381.58 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22 |
12 |
$352.82 |