| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,417 |
1,372 |
$97K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
460 |
442 |
$41K |
| V2020 |
Frames, purchases |
1,203 |
1,138 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
933 |
900 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
608 |
507 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
867 |
823 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
662 |
630 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
232 |
212 |
$4K |
| 92370 |
|
143 |
137 |
$4K |
| 92015 |
Determination of refractive state |
165 |
156 |
$917.04 |
| 92250 |
|
15 |
12 |
$475.69 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
14 |
$295.20 |
| V2715 |
Prism, per lens |
13 |
13 |
$0.00 |