| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,076 |
1,072 |
$42K |
| V2020 |
Frames, purchases |
489 |
489 |
$7K |
| 92015 |
Determination of refractive state |
474 |
471 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
128 |
127 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
302 |
275 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
66 |
66 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
29 |
$976.24 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
108 |
73 |
$800.68 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
16 |
$246.48 |