| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
288 |
271 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
130 |
122 |
$11K |
| V2020 |
Frames, purchases |
447 |
415 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
156 |
144 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
135 |
123 |
$2K |
| 92015 |
Determination of refractive state |
463 |
430 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
63 |
60 |
$1K |