| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
419 |
374 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
448 |
395 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
145 |
139 |
$12K |
| 92015 |
Determination of refractive state |
585 |
533 |
$10K |
| V2020 |
Frames, purchases |
617 |
548 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
646 |
588 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
16 |
$490.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
12 |
$104.50 |