| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,369 |
1,369 |
$131K |
| V2020 |
Frames, purchases |
3,192 |
3,123 |
$121K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,310 |
3,411 |
$97K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
341 |
341 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
397 |
397 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
422 |
421 |
$38K |
| 92015 |
Determination of refractive state |
1,943 |
1,942 |
$35K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
437 |
428 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,614 |
799 |
$2K |