| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,758 |
1,737 |
$240K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,915 |
1,886 |
$217K |
| V2020 |
Frames, purchases |
1,988 |
1,976 |
$99K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,898 |
1,828 |
$35K |
| V2025 |
Deluxe frame |
662 |
611 |
$25K |
| 92015 |
Determination of refractive state |
2,696 |
2,695 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
457 |
418 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
264 |
262 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
960 |
960 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
69 |
69 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
16 |
$944.32 |