| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
858 |
785 |
$27K |
| 92283 |
|
677 |
622 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
159 |
151 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
679 |
452 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
84 |
79 |
$6K |
| V2020 |
Frames, purchases |
593 |
563 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
168 |
149 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
259 |
150 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
63 |
54 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
66 |
65 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
107 |
$2K |
| 92250 |
|
61 |
59 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
24 |
$1K |
| 99072 |
|
117 |
98 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
24 |
$0.00 |