| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,552 |
2,460 |
$249K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,362 |
2,291 |
$164K |
| V2020 |
Frames, purchases |
1,218 |
1,132 |
$59K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
607 |
530 |
$33K |
| 92015 |
Determination of refractive state |
6,546 |
6,295 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,868 |
1,856 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
203 |
182 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
246 |
209 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
26 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
24 |
$911.18 |