| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
221 |
201 |
$10K |
| 92250 |
|
266 |
263 |
$9K |
| V2020 |
Frames, purchases |
425 |
419 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
162 |
161 |
$7K |
| 92083 |
|
161 |
158 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
42 |
42 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
62 |
60 |
$2K |
| 92285 |
|
26 |
26 |
$431.46 |
| 92015 |
Determination of refractive state |
17 |
17 |
$156.24 |