| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,975 |
1,964 |
$108K |
| V2020 |
Frames, purchases |
1,592 |
1,586 |
$87K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,052 |
1,044 |
$55K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
547 |
547 |
$30K |
| 92015 |
Determination of refractive state |
1,055 |
1,049 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
112 |
112 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
46 |
40 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
40 |
$2K |
| V2025 |
Deluxe frame |
17 |
17 |
$812.11 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$68.40 |