| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
479 |
472 |
$28K |
| V2020 |
Frames, purchases |
923 |
886 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
597 |
575 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
120 |
118 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$666.06 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$65.00 |
| 92015 |
Determination of refractive state |
12 |
12 |
$0.00 |