| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
357 |
352 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
202 |
202 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
457 |
230 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
343 |
295 |
$7K |
| V2020 |
Frames, purchases |
283 |
281 |
$3K |
| 92015 |
Determination of refractive state |
345 |
345 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
22 |
$972.66 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
52 |
52 |
$555.00 |
| 92134 |
|
12 |
12 |
$33.85 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
139 |
71 |
$0.00 |