| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,105 |
1,104 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
411 |
411 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
324 |
324 |
$13K |
| V2020 |
Frames, purchases |
507 |
507 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
103 |
103 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54 |
53 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
147 |
147 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
27 |
$768.60 |