| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
305 |
281 |
$26K |
| V2020 |
Frames, purchases |
487 |
433 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
188 |
156 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
175 |
170 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16 |
15 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
88 |
78 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
18 |
14 |
$173.04 |
| 92015 |
Determination of refractive state |
331 |
288 |
$0.00 |