| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
742 |
742 |
$81K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,414 |
1,408 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
309 |
309 |
$41K |
| 92015 |
Determination of refractive state |
1,716 |
1,715 |
$30K |
| V2020 |
Frames, purchases |
1,508 |
1,507 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
543 |
543 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
476 |
476 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
46 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,403 |
1,401 |
$0.00 |