| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
27 |
27 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
84 |
84 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
44 |
44 |
$667.39 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$644.00 |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
52 |
51 |
$512.54 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
71 |
71 |
$294.05 |