| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
65 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
463 |
463 |
$0.00 |
| V2020 |
Frames, purchases |
671 |
671 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
81 |
81 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
100 |
50 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
730 |
388 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
386 |
214 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
114 |
114 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
33 |
33 |
$0.00 |