| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,101 |
1,060 |
$81K |
| V2020 |
Frames, purchases |
869 |
841 |
$57K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
687 |
678 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
330 |
321 |
$15K |
| 92015 |
Determination of refractive state |
778 |
759 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
139 |
136 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
24 |
$970.85 |