| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,446 |
4,445 |
$465K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,382 |
1,382 |
$175K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,605 |
4,600 |
$131K |
| 92015 |
Determination of refractive state |
5,581 |
5,577 |
$99K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,754 |
2,749 |
$67K |
| V2020 |
Frames, purchases |
4,885 |
4,869 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
564 |
563 |
$13K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
36 |
36 |
$725.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$685.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,309 |
3,308 |
$0.00 |