| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,748 |
2,719 |
$111K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,852 |
1,830 |
$42K |
| V2020 |
Frames, purchases |
2,115 |
2,088 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
521 |
512 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,029 |
1,026 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,543 |
1,529 |
$16K |
| 92015 |
Determination of refractive state |
512 |
502 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
93 |
91 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
27 |
$1K |