| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,229 |
1,212 |
$91K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,458 |
1,445 |
$38K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
452 |
446 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,017 |
1,003 |
$30K |
| V2020 |
Frames, purchases |
1,214 |
1,197 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
801 |
790 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
182 |
169 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
41 |
41 |
$3K |
| 92015 |
Determination of refractive state |
158 |
156 |
$2K |
| 92250 |
|
13 |
13 |
$361.19 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$146.25 |