| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
248 |
248 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
114 |
111 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
54 |
44 |
$2K |
| V2020 |
Frames, purchases |
482 |
480 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$2K |
| 92060 |
|
15 |
15 |
$584.34 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
101 |
51 |
$377.10 |
| 92226 |
|
40 |
28 |
$353.34 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
12 |
$212.78 |
| 92225 |
|
31 |
16 |
$150.42 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
210 |
103 |
$0.00 |