| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,507 |
5,447 |
$382K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,316 |
4,292 |
$370K |
| 92015 |
Determination of refractive state |
9,923 |
9,835 |
$149K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
8,370 |
8,309 |
$146K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
118 |
101 |
$5K |
| V2020 |
Frames, purchases |
15 |
15 |
$750.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$300.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
15 |
$150.00 |
| V2760 |
Scratch resistant coating, per lens |
15 |
15 |
$0.00 |