| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
944 |
356 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
821 |
308 |
$21K |
| V2025 |
Deluxe frame |
1,020 |
381 |
$19K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
188 |
67 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
499 |
188 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$45.00 |
| 92015 |
Determination of refractive state |
20 |
12 |
$0.00 |