| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,852 |
3,851 |
$396K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,040 |
1,040 |
$125K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,121 |
3,112 |
$95K |
| 92015 |
Determination of refractive state |
4,324 |
4,323 |
$77K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
959 |
892 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,572 |
1,568 |
$42K |
| V2020 |
Frames, purchases |
3,155 |
3,146 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
894 |
892 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79 |
72 |
$5K |
| 92370 |
|
43 |
43 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$306.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,259 |
3,249 |
$0.00 |