| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
554 |
533 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
237 |
231 |
$21K |
| V2020 |
Frames, purchases |
1,232 |
1,175 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
557 |
538 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
308 |
297 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
16 |
15 |
$711.38 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
13 |
$270.20 |