| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
974 |
882 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
517 |
501 |
$54K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
344 |
337 |
$36K |
| 92250 |
|
1,106 |
1,038 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
768 |
712 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
695 |
353 |
$22K |
| 92015 |
Determination of refractive state |
1,161 |
1,044 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
228 |
225 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
216 |
120 |
$8K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
67 |
32 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
14 |
$754.40 |
| 92341 |
|
16 |
14 |
$532.14 |