| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,255 |
3,255 |
$336K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,388 |
1,388 |
$171K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,967 |
3,953 |
$120K |
| 92015 |
Determination of refractive state |
4,213 |
4,212 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,260 |
2,254 |
$57K |
| V2020 |
Frames, purchases |
4,081 |
4,067 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
829 |
828 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
239 |
218 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
12 |
$463.31 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
15 |
$223.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,013 |
4,001 |
$0.00 |