| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,704 |
1,677 |
$138K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,975 |
1,939 |
$124K |
| 92015 |
Determination of refractive state |
4,592 |
4,393 |
$88K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,208 |
1,154 |
$33K |
| V2020 |
Frames, purchases |
730 |
713 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
440 |
425 |
$8K |
| 92341 |
|
127 |
127 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
142 |
116 |
$3K |
| 92250 |
|
161 |
146 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
87 |
87 |
$711.62 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$585.56 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$421.33 |
| V2756 |
Eye glass case |
590 |
565 |
$306.28 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$80.34 |
| 2023F |
|
602 |
544 |
$0.00 |
| 3072F |
|
18 |
14 |
$0.00 |
| 99072 |
|
422 |
372 |
$0.00 |