| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,517 |
2,442 |
$168K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,037 |
991 |
$91K |
| V2020 |
Frames, purchases |
3,160 |
2,983 |
$87K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,570 |
2,452 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,103 |
1,974 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,790 |
1,703 |
$13K |
| 92015 |
Determination of refractive state |
2,828 |
2,725 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
286 |
241 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
348 |
329 |
$5K |
| 92250 |
|
42 |
40 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
14 |
$872.30 |