| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
346 |
330 |
$22K |
| 92015 |
Determination of refractive state |
698 |
669 |
$10K |
| V2020 |
Frames, purchases |
307 |
288 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
53 |
53 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
86 |
77 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$374.99 |
| V2756 |
Eye glass case |
270 |
252 |
$242.46 |