| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,730 |
3,730 |
$406K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,201 |
1,201 |
$152K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,595 |
4,587 |
$137K |
| 92015 |
Determination of refractive state |
5,186 |
5,186 |
$92K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,265 |
3,257 |
$81K |
| V2020 |
Frames, purchases |
4,862 |
4,841 |
$48K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,082 |
1,081 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
106 |
106 |
$10K |
| 92370 |
|
155 |
151 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
82 |
82 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,640 |
4,631 |
$0.00 |