| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,046 |
6,232 |
$462K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,245 |
5,699 |
$229K |
| V2020 |
Frames, purchases |
12,421 |
10,755 |
$202K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,408 |
3,076 |
$201K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
9,410 |
8,721 |
$103K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,195 |
1,829 |
$78K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,556 |
2,344 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,678 |
1,386 |
$15K |
| V2025 |
Deluxe frame |
398 |
191 |
$15K |
| 92015 |
Determination of refractive state |
189 |
181 |
$2K |
| V2799 |
Vision item or service, miscellaneous |
271 |
221 |
$2K |
| 92202 |
|
110 |
96 |
$24.06 |
| 92225 |
|
24 |
12 |
$0.99 |
| 3072F |
|
31 |
30 |
$0.00 |