| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
940 |
905 |
$22K |
| V2020 |
Frames, purchases |
1,109 |
1,071 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
304 |
290 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
592 |
568 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
175 |
170 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
129 |
125 |
$5K |
| 92250 |
|
51 |
48 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
39 |
39 |
$776.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$639.98 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$536.68 |
| 92341 |
|
25 |
24 |
$448.96 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$270.29 |