| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,320 |
2,200 |
$198K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,596 |
2,463 |
$182K |
| V2020 |
Frames, purchases |
4,262 |
4,025 |
$68K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,812 |
2,625 |
$47K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,416 |
3,251 |
$43K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
454 |
433 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
363 |
347 |
$4K |
| V2799 |
Vision item or service, miscellaneous |
112 |
112 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
71 |
66 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
52 |
48 |
$698.90 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$681.80 |
| 92015 |
Determination of refractive state |
4,664 |
4,386 |
$0.00 |