| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
580 |
499 |
$42K |
| V2020 |
Frames, purchases |
526 |
416 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
323 |
195 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
76 |
69 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
53 |
50 |
$635.16 |
| 92015 |
Determination of refractive state |
1,114 |
911 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
44 |
41 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
48 |
42 |
$0.00 |