| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,167 |
3,167 |
$316K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,292 |
1,292 |
$152K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,432 |
2,432 |
$73K |
| 92015 |
Determination of refractive state |
4,044 |
4,044 |
$72K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,337 |
2,337 |
$65K |
| V2020 |
Frames, purchases |
2,534 |
2,534 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46 |
41 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20 |
20 |
$544.05 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,519 |
2,519 |
$0.00 |