| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
341 |
327 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
414 |
395 |
$9K |
| 92015 |
Determination of refractive state |
478 |
460 |
$4K |
| 92341 |
|
31 |
30 |
$835.06 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
13 |
$445.40 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
56 |
$303.00 |
| 92250 |
|
46 |
43 |
$99.40 |
| V2020 |
Frames, purchases |
178 |
168 |
$0.00 |
| 3072F |
|
30 |
28 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
14 |
$0.00 |