| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,631 |
1,582 |
$137K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,060 |
1,030 |
$73K |
| 92015 |
Determination of refractive state |
3,089 |
2,976 |
$46K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,244 |
2,218 |
$40K |
| 92250 |
|
787 |
713 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
876 |
861 |
$17K |
| 92020 |
|
401 |
361 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
41 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
245 |
238 |
$1K |
| 76514 |
|
79 |
67 |
$553.53 |
| 92083 |
|
19 |
13 |
$394.75 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
15 |
$63.00 |