| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
888 |
815 |
$74K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,035 |
961 |
$41K |
| V2020 |
Frames, purchases |
749 |
707 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
405 |
391 |
$27K |
| 92015 |
Determination of refractive state |
1,584 |
1,478 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
597 |
561 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
479 |
446 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
160 |
140 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
20 |
12 |
$671.00 |
| V2760 |
Scratch resistant coating, per lens |
18 |
16 |
$432.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$301.00 |