| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
936 |
933 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,905 |
1,888 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
376 |
376 |
$21K |
| 92015 |
Determination of refractive state |
1,869 |
1,859 |
$19K |
| V2020 |
Frames, purchases |
1,065 |
1,061 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,094 |
714 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,777 |
1,062 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
198 |
168 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
14 |
$698.75 |
| 92250 |
|
17 |
16 |
$602.61 |