| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
37 |
$3K |
| V2020 |
Frames, purchases |
117 |
113 |
$3K |
| 92015 |
Determination of refractive state |
318 |
273 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
24 |
24 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
26 |
$979.30 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
26 |
25 |
$296.64 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$150.72 |
| 2026F |
|
15 |
15 |
$0.00 |