| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
883 |
759 |
$68K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
342 |
310 |
$22K |
| V2020 |
Frames, purchases |
833 |
756 |
$15K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
167 |
133 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
374 |
336 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
418 |
370 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
73 |
73 |
$973.62 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$202.65 |