| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,510 |
1,320 |
$119K |
| V2020 |
Frames, purchases |
3,481 |
3,299 |
$107K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,972 |
1,103 |
$62K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
695 |
645 |
$44K |
| 92015 |
Determination of refractive state |
3,037 |
2,784 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
907 |
525 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
27 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
56 |
38 |
$1K |
| 92250 |
|
16 |
15 |
$339.62 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$0.00 |