| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
504 |
398 |
$20K |
| V2020 |
Frames, purchases |
355 |
339 |
$14K |
| 92015 |
Determination of refractive state |
1,419 |
1,027 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
40 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45 |
42 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
126 |
64 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
92 |
50 |
$765.31 |