| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
652 |
521 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
134 |
91 |
$4K |
| V2020 |
Frames, purchases |
121 |
107 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
29 |
$3K |
| 92250 |
|
48 |
40 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
43 |
43 |
$898.70 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$765.82 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$526.50 |