| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
311 |
311 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
521 |
520 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
110 |
110 |
$12K |
| 92015 |
Determination of refractive state |
670 |
669 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
130 |
130 |
$11K |
| V2020 |
Frames, purchases |
552 |
549 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
129 |
129 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
41 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
99 |
99 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
496 |
493 |
$0.00 |