| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
572 |
563 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
126 |
122 |
$11K |
| V2020 |
Frames, purchases |
716 |
695 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
526 |
518 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
192 |
168 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
41 |
$914.10 |
| 92015 |
Determination of refractive state |
14 |
14 |
$133.00 |
| 2026F |
|
23 |
23 |
$0.00 |