| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,254 |
1,105 |
$97K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
869 |
821 |
$58K |
| V2020 |
Frames, purchases |
2,598 |
2,345 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
759 |
705 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
877 |
850 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
467 |
407 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
169 |
160 |
$2K |
| V2025 |
Deluxe frame |
28 |
13 |
$492.90 |
| 92015 |
Determination of refractive state |
185 |
123 |
$0.00 |