| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
730 |
713 |
$34K |
| 92015 |
Determination of refractive state |
1,328 |
1,288 |
$24K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
513 |
493 |
$22K |
| 92250 |
|
232 |
213 |
$10K |
| V2020 |
Frames, purchases |
278 |
278 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
158 |
158 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
59 |
55 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
106 |
53 |
$742.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
132 |
132 |
$330.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
20 |
12 |
$140.00 |