| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,542 |
1,416 |
$103K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
633 |
580 |
$50K |
| V2020 |
Frames, purchases |
3,209 |
2,877 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,349 |
917 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,435 |
813 |
$15K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,001 |
904 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
666 |
631 |
$7K |
| 92015 |
Determination of refractive state |
2,662 |
2,379 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
21 |
13 |
$882.26 |