| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
451 |
414 |
$38K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
283 |
269 |
$19K |
| V2020 |
Frames, purchases |
642 |
603 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
172 |
164 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
219 |
205 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
125 |
119 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$173.04 |
| 92015 |
Determination of refractive state |
871 |
828 |
$0.00 |
| 99072 |
|
29 |
27 |
$0.00 |