| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
556 |
539 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
312 |
302 |
$27K |
| V2020 |
Frames, purchases |
729 |
688 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
67 |
66 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
33 |
32 |
$768.52 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
12 |
$691.68 |
| V2756 |
Eye glass case |
690 |
652 |
$682.56 |