| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,384 |
2,267 |
$204K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,168 |
2,066 |
$152K |
| V2020 |
Frames, purchases |
4,377 |
4,068 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,444 |
2,220 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,122 |
1,063 |
$21K |
| 92015 |
Determination of refractive state |
4,148 |
3,826 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
207 |
206 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
39 |
39 |
$0.00 |