| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
224 |
211 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
127 |
121 |
$3K |
| V2020 |
Frames, purchases |
90 |
53 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
43 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
54 |
14 |
$1K |
| 92002 |
|
13 |
13 |
$520.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$457.12 |
| 92015 |
Determination of refractive state |
137 |
137 |
$42.57 |