| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
457 |
393 |
$34K |
| V2020 |
Frames, purchases |
692 |
561 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
496 |
277 |
$5K |
| 92250 |
|
151 |
133 |
$5K |
| 92015 |
Determination of refractive state |
929 |
755 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
41 |
37 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
128 |
125 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$556.51 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
19 |
12 |
$160.62 |