| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,625 |
1,559 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,605 |
1,530 |
$46K |
| 92015 |
Determination of refractive state |
2,322 |
2,231 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
559 |
530 |
$25K |
| V2020 |
Frames, purchases |
429 |
415 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
173 |
167 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62 |
54 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
27 |
$753.45 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
56 |
$618.86 |
| 92341 |
|
14 |
12 |
$421.02 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
19 |
14 |
$299.50 |
| 2022F |
|
17 |
14 |
$0.00 |