| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,600 |
8,599 |
$892K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,974 |
3,974 |
$488K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,245 |
10,232 |
$285K |
| 92015 |
Determination of refractive state |
12,284 |
12,214 |
$217K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,310 |
7,302 |
$214K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,734 |
2,725 |
$208K |
| 92250 |
|
5,795 |
5,793 |
$182K |
| V2020 |
Frames, purchases |
9,870 |
9,865 |
$99K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
446 |
415 |
$25K |
| 92133 |
|
145 |
144 |
$4K |
| V2700 |
Balance lens, per lens |
25 |
25 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,814 |
9,803 |
$0.00 |