| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,357 |
1,336 |
$56K |
| V2020 |
Frames, purchases |
1,603 |
1,573 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,229 |
1,203 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
661 |
642 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
811 |
792 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
171 |
171 |
$6K |
| 92015 |
Determination of refractive state |
2,331 |
2,288 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
25 |
25 |
$486.87 |
| 92341 |
|
12 |
12 |
$184.79 |