| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,150 |
1,058 |
$89K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
443 |
399 |
$35K |
| V2020 |
Frames, purchases |
1,358 |
1,171 |
$26K |
| 92015 |
Determination of refractive state |
2,050 |
1,847 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
49 |
46 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,041 |
891 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
119 |
101 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
973 |
501 |
$1K |
| 92250 |
|
53 |
44 |
$337.63 |
| 92285 |
|
44 |
39 |
$232.50 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
43 |
25 |
$194.88 |
| 92341 |
|
12 |
12 |
$165.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
24 |
14 |
$0.00 |