| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
415 |
377 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
430 |
397 |
$28K |
| V2025 |
Deluxe frame |
407 |
394 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
421 |
390 |
$8K |
| V2020 |
Frames, purchases |
359 |
337 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
216 |
211 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
324 |
319 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
28 |
28 |
$14.82 |
| 92015 |
Determination of refractive state |
330 |
280 |
$9.50 |
| V2750 |
Anti-reflective coating, per lens |
24 |
24 |
$0.00 |