| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
208 |
201 |
$9K |
| V2025 |
Deluxe frame |
49 |
42 |
$3K |
| 92015 |
Determination of refractive state |
273 |
256 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
16 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
68 |
58 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
40 |
24 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$0.00 |