| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
673 |
618 |
$45K |
| 92015 |
Determination of refractive state |
1,109 |
940 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
234 |
202 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
111 |
109 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
218 |
214 |
$4K |
| 92314 |
|
25 |
25 |
$4K |
| V2020 |
Frames, purchases |
328 |
317 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
55 |
55 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
94 |
$876.42 |
| V2760 |
Scratch resistant coating, per lens |
56 |
56 |
$560.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
57 |
57 |
$224.00 |