| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
523 |
509 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
258 |
250 |
$22K |
| V2020 |
Frames, purchases |
634 |
560 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
375 |
374 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
288 |
252 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
155 |
146 |
$3K |
| 92015 |
Determination of refractive state |
806 |
717 |
$0.00 |