| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,569 |
2,515 |
$96K |
| 92310 |
|
830 |
814 |
$29K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
285 |
281 |
$12K |
| 92015 |
Determination of refractive state |
3,048 |
2,973 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
218 |
216 |
$5K |
| V2020 |
Frames, purchases |
196 |
196 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
57 |
52 |
$2K |
| 92250 |
|
54 |
52 |
$2K |
| 92341 |
|
69 |
67 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
92 |
92 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
79 |
79 |
$950.00 |
| V2025 |
Deluxe frame |
26 |
26 |
$442.00 |