| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
439 |
399 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
372 |
329 |
$23K |
| V2020 |
Frames, purchases |
891 |
833 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
759 |
732 |
$10K |
| V2760 |
Scratch resistant coating, per lens |
521 |
504 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
187 |
179 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
24 |
$574.67 |
| 92015 |
Determination of refractive state |
73 |
67 |
$0.00 |