| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
364 |
335 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
86 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
86 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
27 |
25 |
$2K |
| 92015 |
Determination of refractive state |
208 |
170 |
$404.40 |
| V2020 |
Frames, purchases |
74 |
37 |
$277.50 |
| S9999 |
Sales tax |
12 |
12 |
$22.02 |