| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
458 |
458 |
$329K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
233 |
232 |
$166K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52 |
49 |
$37K |
| V2020 |
Frames, purchases |
552 |
551 |
$6K |
| 92133 |
|
13 |
13 |
$719.00 |
| V2199 |
Not otherwise classified, single vision lens |
332 |
332 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
500 |
500 |
$0.00 |
| 92015 |
Determination of refractive state |
288 |
288 |
$0.00 |
| V2781 |
Progressive lens, per lens |
133 |
133 |
$0.00 |