| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,433 |
1,392 |
$109K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,833 |
1,743 |
$77K |
| V2020 |
Frames, purchases |
2,043 |
1,909 |
$74K |
| 92015 |
Determination of refractive state |
2,898 |
2,732 |
$49K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
313 |
283 |
$28K |
| 92250 |
|
312 |
298 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
337 |
328 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
550 |
536 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
665 |
635 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
706 |
663 |
$16K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
81 |
73 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
51 |
$4K |
| 92341 |
|
112 |
101 |
$2K |
| 92002 |
|
45 |
45 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
49 |
42 |
$2K |
| V2756 |
Eye glass case |
1,514 |
1,415 |
$2K |
| 92060 |
|
40 |
37 |
$2K |