| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,148 |
1,895 |
$105K |
| 92015 |
Determination of refractive state |
7,737 |
6,594 |
$102K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,360 |
1,308 |
$84K |
| V2020 |
Frames, purchases |
2,297 |
2,216 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
272 |
244 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
552 |
421 |
$17K |
| V2756 |
Eye glass case |
2,221 |
2,148 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
273 |
174 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
59 |
58 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
22 |
12 |
$165.44 |
| 92134 |
|
13 |
12 |
$111.42 |