| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
4,140 |
3,857 |
$49K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
617 |
576 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
745 |
720 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,752 |
1,694 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
809 |
766 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
771 |
711 |
$28K |
| V2020 |
Frames, purchases |
734 |
718 |
$10K |
| 92341 |
|
248 |
236 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
295 |
229 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
57 |
51 |
$2K |
| 92250 |
|
58 |
52 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
62 |
62 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
92 |
92 |
$672.59 |