| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,420 |
1,353 |
$87K |
| 92250 |
|
1,679 |
1,629 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,917 |
1,074 |
$35K |
| V2020 |
Frames, purchases |
1,198 |
1,174 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
225 |
220 |
$11K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
12 |
$706.10 |
| 92015 |
Determination of refractive state |
212 |
209 |
$49.32 |