| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
612 |
600 |
$36K |
| V2020 |
Frames, purchases |
487 |
470 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
98 |
96 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
288 |
286 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
73 |
71 |
$2K |
| 92015 |
Determination of refractive state |
72 |
72 |
$697.30 |
| 2026F |
|
146 |
135 |
$0.00 |