| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
69 |
66 |
$5K |
| V2020 |
Frames, purchases |
162 |
145 |
$2K |
| 92015 |
Determination of refractive state |
176 |
169 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
42 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
29 |
$373.20 |
| 92250 |
|
168 |
159 |
$343.47 |