| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,871 |
2,749 |
$96K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,510 |
1,459 |
$86K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,077 |
1,949 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
576 |
557 |
$46K |
| V2020 |
Frames, purchases |
2,008 |
1,907 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,639 |
1,265 |
$28K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
16 |
16 |
$847.30 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
32 |
16 |
$316.72 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
25 |
24 |
$291.06 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
12 |
$215.40 |
| V2702 |
Deluxe lens feature |
235 |
222 |
$0.00 |