| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
690 |
689 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
427 |
421 |
$18K |
| 92015 |
Determination of refractive state |
1,203 |
1,198 |
$16K |
| V2020 |
Frames, purchases |
299 |
293 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
290 |
288 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
313 |
308 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
124 |
124 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$558.54 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$121.22 |