| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
248 |
237 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
295 |
272 |
$14K |
| 92015 |
Determination of refractive state |
946 |
826 |
$9K |
| V2020 |
Frames, purchases |
170 |
170 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
88 |
83 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
24 |
24 |
$572.24 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
12 |
$172.16 |