| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,183 |
2,158 |
$137K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
561 |
559 |
$42K |
| 92015 |
Determination of refractive state |
3,035 |
3,004 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,207 |
1,150 |
$23K |
| V2020 |
Frames, purchases |
332 |
322 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
143 |
137 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
68 |
61 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
246 |
167 |
$2K |
| 92341 |
|
79 |
79 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
37 |
36 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
45 |
28 |
$0.00 |