| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
437 |
435 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
564 |
282 |
$6K |
| V2020 |
Frames, purchases |
747 |
743 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
121 |
118 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
147 |
147 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
237 |
118 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$303.01 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
30 |
15 |
$246.48 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
864 |
430 |
$0.00 |