| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
401 |
350 |
$27K |
| V2020 |
Frames, purchases |
690 |
619 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
358 |
345 |
$10K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
408 |
377 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
48 |
$5K |
| 92015 |
Determination of refractive state |
241 |
238 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
48 |
25 |
$554.10 |
| V2799 |
Vision item or service, miscellaneous |
39 |
39 |
$222.30 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15 |
15 |
$193.38 |