| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
220 |
183 |
$14K |
| V2020 |
Frames, purchases |
178 |
146 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
134 |
110 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
31 |
$394.25 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
29 |
29 |
$202.65 |
| 92015 |
Determination of refractive state |
38 |
32 |
$142.89 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21 |
21 |
$0.00 |
| 2023F |
|
122 |
115 |
$0.00 |