| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
259 |
172 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
43 |
$3K |
| V2020 |
Frames, purchases |
311 |
308 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
42 |
41 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 92250 |
|
13 |
13 |
$589.24 |
| 92082 |
|
13 |
13 |
$465.40 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
144 |
78 |
$122.00 |