| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,391 |
7,391 |
$800K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,594 |
2,594 |
$334K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
10,743 |
10,715 |
$325K |
| 92015 |
Determination of refractive state |
12,057 |
12,056 |
$214K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,627 |
4,614 |
$113K |
| V2020 |
Frames, purchases |
11,293 |
11,254 |
$113K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,569 |
3,560 |
$89K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
718 |
686 |
$38K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
396 |
396 |
$30K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
611 |
610 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
148 |
147 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
11,020 |
10,984 |
$23.13 |