| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
227 |
181 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
180 |
143 |
$6K |
| V2020 |
Frames, purchases |
94 |
82 |
$651.40 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$172.98 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
64 |
64 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
14 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
29 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$0.00 |
| 92015 |
Determination of refractive state |
359 |
314 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
49 |
38 |
$0.00 |
| 99072 |
|
15 |
15 |
$0.00 |