| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,562 |
2,529 |
$171K |
| V2020 |
Frames, purchases |
2,743 |
2,727 |
$87K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
881 |
861 |
$78K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,985 |
1,968 |
$58K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,562 |
1,549 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,671 |
1,657 |
$13K |
| 92341 |
|
209 |
209 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
258 |
258 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
108 |
107 |
$2K |
| 92015 |
Determination of refractive state |
3,488 |
3,442 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
32 |
$1K |
| 92370 |
|
42 |
42 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
25 |
25 |
$420.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$190.00 |