| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
220 |
220 |
$14K |
| V2020 |
Frames, purchases |
152 |
144 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
217 |
216 |
$10K |
| 92015 |
Determination of refractive state |
677 |
662 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
333 |
327 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
169 |
132 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
61 |
61 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$1K |
| 92250 |
|
28 |
25 |
$58.40 |
| 92225 |
|
13 |
13 |
$0.00 |