| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
903 |
891 |
$81K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
666 |
664 |
$52K |
| 92250 |
|
946 |
911 |
$38K |
| V2020 |
Frames, purchases |
1,858 |
1,839 |
$29K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
831 |
825 |
$20K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,429 |
1,417 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
566 |
559 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
284 |
284 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
155 |
155 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
15 |
$839.51 |
| 92285 |
|
14 |
14 |
$355.96 |