| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
123 |
123 |
$5K |
| V2020 |
Frames, purchases |
88 |
88 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
121 |
67 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
64 |
46 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
83 |
83 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$694.68 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
19 |
19 |
$223.50 |