| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
332 |
331 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
179 |
176 |
$17K |
| 92065 |
|
333 |
111 |
$7K |
| 97112 |
Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination |
333 |
111 |
$6K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
333 |
111 |
$6K |
| V2020 |
Frames, purchases |
206 |
203 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
141 |
141 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
217 |
213 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
39 |
$952.60 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$318.70 |
| 92015 |
Determination of refractive state |
545 |
538 |
$60.00 |