| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
855 |
829 |
$46K |
| V2020 |
Frames, purchases |
1,733 |
1,704 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,192 |
1,171 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
641 |
636 |
$25K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
555 |
548 |
$20K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
589 |
579 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
915 |
908 |
$19K |
| 92015 |
Determination of refractive state |
807 |
798 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
744 |
731 |
$8K |
| 92341 |
|
266 |
263 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
119 |
119 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$925.96 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$693.12 |
| 92134 |
|
26 |
26 |
$300.00 |
| 2023F |
|
62 |
59 |
$0.00 |