| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
685 |
685 |
$35K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
922 |
913 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
175 |
175 |
$12K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
295 |
292 |
$9K |
| V2500 |
Contact lens, pmma, spherical, per lens |
131 |
127 |
$9K |
| 92015 |
Determination of refractive state |
1,153 |
1,153 |
$8K |
| V2020 |
Frames, purchases |
78 |
78 |
$6K |
| 92310 |
|
103 |
95 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$565.00 |