| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,656 |
1,592 |
$120K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,326 |
1,264 |
$96K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,766 |
2,595 |
$15K |
| V2020 |
Frames, purchases |
2,864 |
2,673 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,155 |
1,112 |
$8K |
| 92015 |
Determination of refractive state |
3,097 |
2,960 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
960 |
867 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,385 |
1,320 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
15 |
$557.43 |