| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,892 |
1,889 |
$146K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,767 |
1,763 |
$128K |
| V2020 |
Frames, purchases |
2,473 |
2,453 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,010 |
1,061 |
$41K |
| 92015 |
Determination of refractive state |
905 |
905 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
63 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
469 |
247 |
$250.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$180.00 |