| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
992 |
954 |
$86K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
829 |
795 |
$52K |
| V2020 |
Frames, purchases |
1,003 |
946 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
753 |
666 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
810 |
784 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
425 |
422 |
$8K |
| 92015 |
Determination of refractive state |
435 |
400 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
38 |
38 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
329 |
315 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
27 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
71 |
57 |
$1K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
32 |
30 |
$737.25 |
| V2760 |
Scratch resistant coating, per lens |
281 |
277 |
$555.04 |