| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
677 |
664 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
109 |
93 |
$4K |
| 92341 |
|
13 |
13 |
$350.61 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
25 |
$288.00 |
| 92015 |
Determination of refractive state |
38 |
25 |
$225.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
727 |
714 |
$72.00 |
| V2020 |
Frames, purchases |
531 |
521 |
$0.00 |
| V2025 |
Deluxe frame |
15 |
15 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
303 |
294 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |