| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,394 |
1,359 |
$93K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
750 |
740 |
$69K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,413 |
1,395 |
$44K |
| V2020 |
Frames, purchases |
1,472 |
1,410 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
890 |
788 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,330 |
1,277 |
$10K |
| 92015 |
Determination of refractive state |
1,709 |
1,658 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
249 |
232 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
709 |
694 |
$1K |
| 92370 |
|
25 |
25 |
$731.29 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$513.69 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
44 |
39 |
$504.22 |