| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
378 |
335 |
$28K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
132 |
121 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
165 |
152 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
147 |
136 |
$12K |
| V2025 |
Deluxe frame |
125 |
116 |
$9K |
| V2750 |
Anti-reflective coating, per lens |
154 |
143 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
132 |
121 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
29 |
$2K |
| 92015 |
Determination of refractive state |
471 |
434 |
$803.57 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
24 |
14 |
$685.38 |
| 92133 |
|
17 |
15 |
$460.01 |