| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
892 |
489 |
$59K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
845 |
548 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
284 |
276 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,314 |
797 |
$14K |
| V2020 |
Frames, purchases |
1,397 |
878 |
$9K |
| 92015 |
Determination of refractive state |
2,083 |
1,265 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,366 |
908 |
$5K |
| V2025 |
Deluxe frame |
30 |
30 |
$676.50 |
| 2023F |
|
40 |
40 |
$0.00 |
| V2755 |
U-v lens, per lens |
65 |
55 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
30 |
$0.00 |