| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
291 |
276 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
98 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
119 |
118 |
$3K |
| V2020 |
Frames, purchases |
117 |
115 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
18 |
$720.45 |