| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,347 |
1,255 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,177 |
1,141 |
$52K |
| 92015 |
Determination of refractive state |
2,484 |
2,420 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
867 |
835 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
547 |
464 |
$22K |
| V2020 |
Frames, purchases |
723 |
703 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
341 |
265 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
382 |
375 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
41 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
46 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
90 |
90 |
$950.62 |
| V2025 |
Deluxe frame |
45 |
45 |
$494.50 |