| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
832 |
829 |
$38K |
| 92015 |
Determination of refractive state |
1,454 |
1,450 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
508 |
508 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
841 |
822 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
94 |
93 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
133 |
129 |
$6K |
| 92341 |
|
14 |
14 |
$377.58 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
929 |
914 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
523 |
514 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
28 |
$0.00 |
| V2020 |
Frames, purchases |
923 |
905 |
$0.00 |