| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
848 |
847 |
$90K |
| 92015 |
Determination of refractive state |
1,896 |
1,875 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
567 |
550 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
193 |
193 |
$17K |
| V2020 |
Frames, purchases |
130 |
129 |
$16K |
| 92341 |
|
295 |
207 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
120 |
112 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$820.24 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
25 |
$601.25 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$593.60 |