| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
157 |
152 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
63 |
63 |
$5K |
| V2020 |
Frames, purchases |
207 |
201 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
38 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
55 |
55 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
30 |
$607.09 |