| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,132 |
1,029 |
$87K |
| V2020 |
Frames, purchases |
2,184 |
2,024 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,199 |
1,105 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
402 |
375 |
$28K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,137 |
1,082 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
89 |
81 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
94 |
89 |
$1K |
| 92015 |
Determination of refractive state |
63 |
35 |
$332.50 |