| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92065 |
|
3,517 |
834 |
$115K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,617 |
841 |
$64K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
159 |
156 |
$11K |
| V2020 |
Frames, purchases |
211 |
210 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
63 |
63 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
140 |
140 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
41 |
39 |
$3K |
| 92060 |
|
38 |
38 |
$2K |
| 92250 |
|
30 |
29 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
21 |
$437.50 |
| 92015 |
Determination of refractive state |
243 |
239 |
$0.00 |
| 99072 |
|
135 |
129 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
31 |
31 |
$0.00 |