| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,778 |
1,778 |
$195K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
948 |
948 |
$124K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,058 |
3,050 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,184 |
2,174 |
$61K |
| 92015 |
Determination of refractive state |
2,694 |
2,693 |
$48K |
| V2020 |
Frames, purchases |
3,120 |
3,111 |
$31K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
649 |
649 |
$18K |
| V2715 |
Prism, per lens |
44 |
44 |
$710.16 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$456.23 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,187 |
3,175 |
$0.00 |