| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
211 |
209 |
$13K |
| V2020 |
Frames, purchases |
222 |
222 |
$7K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
110 |
109 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
242 |
242 |
$5K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
93 |
93 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63 |
57 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
34 |
31 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
94 |
$819.97 |