| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,334 |
5,139 |
$461K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,716 |
5,471 |
$400K |
| 92015 |
Determination of refractive state |
10,553 |
10,016 |
$31K |
| V2020 |
Frames, purchases |
77 |
75 |
$884.40 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
26 |
$435.10 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
15 |
$24.72 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |
| 2025F |
|
2,131 |
2,069 |
$0.00 |
| 2022F |
|
1,601 |
1,573 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
22 |
21 |
$0.00 |