| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,147 |
1,026 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,676 |
1,456 |
$47K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
867 |
755 |
$37K |
| 92015 |
Determination of refractive state |
1,762 |
1,564 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
348 |
256 |
$19K |
| V2020 |
Frames, purchases |
408 |
408 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
288 |
265 |
$11K |
| V2025 |
Deluxe frame |
296 |
204 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
251 |
251 |
$3K |
| 92341 |
|
26 |
26 |
$753.30 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
44 |
$478.50 |
| 92083 |
|
12 |
12 |
$261.80 |
| 92250 |
|
13 |
13 |
$246.23 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$113.40 |