| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
926 |
919 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,888 |
1,871 |
$27K |
| 92015 |
Determination of refractive state |
1,219 |
1,208 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
75 |
75 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
75 |
68 |
$2K |
| V2020 |
Frames, purchases |
1,329 |
1,313 |
$69.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,240 |
1,223 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
133 |
132 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
698 |
690 |
$0.00 |