| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
326 |
319 |
$31K |
| V2020 |
Frames, purchases |
987 |
908 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,050 |
966 |
$21K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
296 |
286 |
$15K |
| 92015 |
Determination of refractive state |
402 |
392 |
$5K |
| V2025 |
Deluxe frame |
27 |
27 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$363.88 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
181 |
166 |
$52.00 |