| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,192 |
3,192 |
$326K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,494 |
3,488 |
$106K |
| 92015 |
Determination of refractive state |
4,369 |
4,369 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
519 |
519 |
$64K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,814 |
1,808 |
$50K |
| V2020 |
Frames, purchases |
3,473 |
3,468 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
24 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
85 |
85 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$864.84 |
| 92250 |
|
12 |
12 |
$302.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,636 |
3,627 |
$0.00 |