| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
141 |
138 |
$12K |
| V2020 |
Frames, purchases |
722 |
636 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
90 |
83 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
445 |
422 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
259 |
220 |
$4K |
| 92015 |
Determination of refractive state |
534 |
485 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
81 |
58 |
$704.52 |
| 92250 |
|
522 |
468 |
$391.08 |
| V2799 |
Vision item or service, miscellaneous |
19 |
14 |
$88.92 |
| 92025 |
|
61 |
58 |
$20.65 |
| 92082 |
|
54 |
51 |
$0.00 |