| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
730 |
722 |
$62K |
| V2020 |
Frames, purchases |
836 |
825 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
509 |
499 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
350 |
345 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
306 |
304 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
69 |
69 |
$6K |
| 92015 |
Determination of refractive state |
376 |
374 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
91 |
91 |
$765.70 |