| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,285 |
2,255 |
$201K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
836 |
831 |
$95K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,679 |
1,651 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
65 |
64 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
29 |
$2K |
| 92015 |
Determination of refractive state |
3,059 |
3,007 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
16 |
$1K |
| V2020 |
Frames, purchases |
1,415 |
1,389 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
887 |
526 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
13 |
$0.00 |