| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,930 |
1,930 |
$242K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,283 |
2,283 |
$241K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,216 |
3,176 |
$98K |
| 92015 |
Determination of refractive state |
3,667 |
3,661 |
$66K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,119 |
2,049 |
$59K |
| V2020 |
Frames, purchases |
3,250 |
3,205 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
943 |
928 |
$25K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
42 |
42 |
$6K |
| 92250 |
|
43 |
43 |
$961.06 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$757.78 |
| 92273 |
|
12 |
12 |
$720.81 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,657 |
3,559 |
$0.00 |