| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
795 |
669 |
$58K |
| V2020 |
Frames, purchases |
1,730 |
1,426 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
775 |
670 |
$46K |
| 92015 |
Determination of refractive state |
1,745 |
1,504 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,291 |
1,079 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
999 |
822 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,670 |
1,390 |
$9K |
| 00000 |
|
90 |
20 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
198 |
169 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
28 |
$1K |
| 92250 |
|
57 |
53 |
$860.56 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
29 |
26 |
$741.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$598.08 |
| 92341 |
|
15 |
12 |
$487.50 |
| V2750 |
Anti-reflective coating, per lens |
18 |
13 |
$381.50 |