| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
448 |
439 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
960 |
949 |
$18K |
| 92250 |
|
616 |
604 |
$13K |
| V2020 |
Frames, purchases |
433 |
430 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
297 |
296 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
237 |
237 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
155 |
154 |
$4K |
| 92015 |
Determination of refractive state |
555 |
552 |
$206.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$96.00 |
| 1036F |
|
27 |
27 |
$0.00 |