| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
307 |
300 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
177 |
176 |
$3K |
| 92015 |
Determination of refractive state |
260 |
257 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19 |
16 |
$653.38 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
16 |
$478.25 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
17 |
$0.00 |