| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
369 |
368 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
445 |
445 |
$20K |
| 92015 |
Determination of refractive state |
248 |
241 |
$4K |
| V2020 |
Frames, purchases |
326 |
325 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
95 |
88 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
60 |
59 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
59 |
59 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
24 |
$552.45 |