| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
892 |
731 |
$49K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
474 |
404 |
$33K |
| V2020 |
Frames, purchases |
1,220 |
822 |
$15K |
| 92015 |
Determination of refractive state |
1,726 |
1,445 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79 |
57 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
520 |
373 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
572 |
335 |
$907.52 |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
26 |
12 |
$521.82 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
12 |
$214.62 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,122 |
738 |
$159.04 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
13 |
$148.59 |
| V2025 |
Deluxe frame |
28 |
20 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
221 |
119 |
$0.00 |