| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
920 |
896 |
$81K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
647 |
627 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,084 |
1,073 |
$33K |
| V2020 |
Frames, purchases |
1,077 |
1,062 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
471 |
428 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
382 |
378 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
400 |
397 |
$7K |
| 92015 |
Determination of refractive state |
449 |
428 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
645 |
639 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
38 |
37 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
517 |
514 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
28 |
$549.40 |