| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
78 |
76 |
$7K |
| 92015 |
Determination of refractive state |
454 |
425 |
$5K |
| V2020 |
Frames, purchases |
148 |
133 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
51 |
49 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
76 |
74 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
34 |
28 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
94 |
85 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
14 |
$596.82 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
59 |
56 |
$456.00 |