| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,917 |
3,881 |
$293K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,150 |
2,142 |
$140K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,463 |
3,387 |
$64K |
| 92015 |
Determination of refractive state |
7,081 |
6,832 |
$63K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
680 |
536 |
$28K |
| 92250 |
|
539 |
526 |
$13K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
84 |
84 |
$8K |
| V2020 |
Frames, purchases |
249 |
245 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
36 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
71 |
$2K |
| 92370 |
|
108 |
106 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$840.38 |
| 2025F |
|
98 |
95 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
41 |
41 |
$0.00 |