| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
747 |
744 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
755 |
753 |
$51K |
| 92015 |
Determination of refractive state |
2,188 |
2,176 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
363 |
346 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,290 |
1,276 |
$20K |
| 96111 |
|
116 |
114 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
129 |
86 |
$5K |
| V2020 |
Frames, purchases |
67 |
67 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
31 |
$1K |