| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,252 |
1,158 |
$43K |
| V2020 |
Frames, purchases |
1,192 |
1,119 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
471 |
447 |
$25K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
766 |
742 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
503 |
466 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
156 |
134 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
30 |
30 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
65 |
64 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
24 |
24 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
19 |
12 |
$1K |
| 92250 |
|
15 |
13 |
$552.63 |