| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,689 |
3,686 |
$75K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,740 |
2,737 |
$51K |
| V2020 |
Frames, purchases |
4,013 |
4,005 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,193 |
3,188 |
$35K |
| 92015 |
Determination of refractive state |
6,277 |
6,270 |
$23K |
| 92341 |
|
437 |
436 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
240 |
228 |
$3K |
| 92250 |
|
266 |
264 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
596 |
533 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
26 |
$805.20 |