| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
339 |
319 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
115 |
105 |
$8K |
| V2020 |
Frames, purchases |
654 |
614 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
236 |
230 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
326 |
188 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
371 |
349 |
$2K |
| 92083 |
|
16 |
16 |
$844.70 |
| 92250 |
|
15 |
15 |
$718.80 |
| 92020 |
|
19 |
19 |
$292.23 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
38 |
30 |
$284.00 |