| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,041 |
914 |
$13K |
| 99222 |
Initial hospital care, per day, moderate complexity |
121 |
113 |
$10K |
| V2020 |
Frames, purchases |
222 |
209 |
$10K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
213 |
140 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
118 |
107 |
$7K |
| 92201 |
|
142 |
97 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
135 |
116 |
$4K |
| 92226 |
|
43 |
14 |
$1K |
| 92225 |
|
30 |
15 |
$961.70 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
25 |
24 |
$786.09 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$331.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
14 |
$313.04 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
13 |
$247.86 |
| V2756 |
Eye glass case |
205 |
194 |
$227.87 |