| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,363 |
1,355 |
$121K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
685 |
672 |
$50K |
| 92015 |
Determination of refractive state |
1,790 |
1,788 |
$37K |
| V2020 |
Frames, purchases |
1,033 |
1,027 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
446 |
441 |
$14K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,028 |
1,022 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
132 |
132 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$826.32 |
| 2023F |
|
93 |
92 |
$0.00 |