| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,078 |
1,969 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
404 |
390 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
345 |
330 |
$8K |
| V2020 |
Frames, purchases |
413 |
390 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
193 |
183 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$485.52 |
| 92015 |
Determination of refractive state |
93 |
85 |
$222.42 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
18 |
17 |
$0.00 |