| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
761 |
730 |
$66K |
| V2020 |
Frames, purchases |
1,052 |
921 |
$22K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
52 |
41 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
94 |
91 |
$7K |
| 92015 |
Determination of refractive state |
1,338 |
1,263 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
763 |
660 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
83 |
66 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
724 |
381 |
$871.30 |
| 92250 |
|
64 |
47 |
$540.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
44 |
12 |
$0.00 |