| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,017 |
3,954 |
$169K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,449 |
2,711 |
$148K |
| V2020 |
Frames, purchases |
3,174 |
3,046 |
$98K |
| 92015 |
Determination of refractive state |
1,278 |
1,263 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,422 |
2,648 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
835 |
820 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
136 |
132 |
$6K |
| 92250 |
|
74 |
74 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
52 |
50 |
$2K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$969.15 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$829.85 |