| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
3,397 |
2,904 |
$208K |
| 92015 |
Determination of refractive state |
7,208 |
6,564 |
$122K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,944 |
2,598 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,595 |
2,364 |
$117K |
| 92285 |
|
3,476 |
3,045 |
$101K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,916 |
2,658 |
$83K |
| 92083 |
|
1,518 |
1,324 |
$53K |
| 92250 |
|
500 |
423 |
$17K |
| 92060 |
|
132 |
132 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
13 |
$585.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
182 |
182 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
313 |
313 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
108 |
108 |
$0.00 |
| V2020 |
Frames, purchases |
422 |
413 |
$0.00 |