| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,640 |
2,640 |
$262K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,053 |
3,046 |
$93K |
| 92015 |
Determination of refractive state |
4,505 |
4,504 |
$79K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
647 |
647 |
$68K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,356 |
1,352 |
$37K |
| V2020 |
Frames, purchases |
3,225 |
3,218 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
88 |
83 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
43 |
41 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
28 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
69 |
68 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,332 |
3,325 |
$147.90 |