| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,152 |
2,152 |
$235K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,260 |
1,260 |
$164K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,955 |
3,953 |
$120K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,217 |
3,210 |
$90K |
| 92015 |
Determination of refractive state |
4,347 |
4,340 |
$77K |
| V2020 |
Frames, purchases |
3,990 |
3,987 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
181 |
178 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
260 |
260 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
28 |
28 |
$781.20 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
15 |
15 |
$418.50 |