| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,518 |
1,515 |
$56K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,370 |
1,364 |
$46K |
| V2020 |
Frames, purchases |
2,517 |
2,502 |
$46K |
| 92015 |
Determination of refractive state |
3,191 |
3,172 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,060 |
1,057 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
644 |
636 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
793 |
788 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
47 |
47 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
91 |
90 |
$2K |
| V2715 |
Prism, per lens |
266 |
261 |
$2K |
| 92225 |
|
16 |
14 |
$1K |
| 92341 |
|
29 |
28 |
$834.22 |
| 92250 |
|
18 |
18 |
$717.50 |
| 92060 |
|
16 |
16 |
$508.36 |
| 92083 |
|
13 |
13 |
$392.60 |