| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,186 |
1,186 |
$143K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,201 |
1,200 |
$116K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,379 |
2,374 |
$69K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,915 |
1,915 |
$47K |
| 92015 |
Determination of refractive state |
2,558 |
2,557 |
$44K |
| V2020 |
Frames, purchases |
2,408 |
2,404 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
75 |
75 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
142 |
142 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,392 |
2,391 |
$0.00 |