| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
791 |
717 |
$117K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
293 |
270 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
675 |
603 |
$9K |
| 92015 |
Determination of refractive state |
1,289 |
1,169 |
$9K |
| V2020 |
Frames, purchases |
1,112 |
997 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
928 |
841 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
51 |
$1K |
| 92250 |
|
110 |
109 |
$212.15 |