| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
143 |
119 |
$4K |
| 92015 |
Determination of refractive state |
188 |
152 |
$4K |
| 92370 |
|
191 |
151 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
118 |
100 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
28 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
25 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
39 |
34 |
$844.00 |