| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
952 |
951 |
$101K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,940 |
1,932 |
$57K |
| 92015 |
Determination of refractive state |
2,029 |
2,026 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,179 |
1,175 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
206 |
206 |
$26K |
| V2020 |
Frames, purchases |
2,069 |
2,057 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74 |
71 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
39 |
$950.79 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,384 |
1,381 |
$0.00 |