| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,489 |
1,392 |
$91K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
454 |
431 |
$40K |
| 92015 |
Determination of refractive state |
2,263 |
2,100 |
$31K |
| V2020 |
Frames, purchases |
1,194 |
1,098 |
$28K |
| 92250 |
|
252 |
228 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
306 |
288 |
$7K |
| V2756 |
Eye glass case |
1,083 |
1,013 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
60 |
37 |
$920.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$765.52 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
16 |
$653.64 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
28 |
27 |
$599.72 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
15 |
$303.47 |