| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
528 |
471 |
$40K |
| 92015 |
Determination of refractive state |
1,353 |
1,176 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
151 |
125 |
$12K |
| V2020 |
Frames, purchases |
326 |
244 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
208 |
169 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
60 |
26 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
79 |
27 |
$1K |
| 92083 |
|
30 |
24 |
$698.18 |