| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,420 |
2,370 |
$52K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
485 |
485 |
$22K |
| 92015 |
Determination of refractive state |
1,002 |
999 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
355 |
355 |
$17K |
| 92341 |
|
320 |
315 |
$9K |
| V2020 |
Frames, purchases |
3,364 |
3,298 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
846 |
825 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
73 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$808.64 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,973 |
2,913 |
$414.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,466 |
1,436 |
$373.20 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
49 |
49 |
$74.64 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
182 |
179 |
$0.00 |
| V2781 |
Progressive lens, per lens |
48 |
47 |
$0.00 |