| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
928 |
914 |
$78K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
718 |
715 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,132 |
1,125 |
$42K |
| V2020 |
Frames, purchases |
821 |
819 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
250 |
228 |
$12K |
| 92015 |
Determination of refractive state |
1,977 |
1,953 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
430 |
428 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
487 |
486 |
$5K |
| 92250 |
|
60 |
58 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
41 |
41 |
$315.72 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$85.12 |