| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
820 |
796 |
$76K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
697 |
681 |
$53K |
| V2020 |
Frames, purchases |
1,202 |
1,139 |
$43K |
| 92015 |
Determination of refractive state |
2,899 |
2,760 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
92 |
87 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
157 |
93 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
67 |
39 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
38 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
12 |
$699.80 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
28 |
28 |
$420.00 |