| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
721 |
638 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
317 |
300 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71 |
70 |
$3K |
| 92015 |
Determination of refractive state |
1,484 |
1,330 |
$1K |
| V2020 |
Frames, purchases |
28 |
26 |
$969.54 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
86 |
40 |
$570.96 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
28 |
26 |
$474.39 |
| V2750 |
Anti-reflective coating, per lens |
28 |
13 |
$320.32 |