| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
341 |
328 |
$13K |
| V2020 |
Frames, purchases |
205 |
181 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
74 |
60 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
47 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
80 |
78 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
43 |
41 |
$948.00 |
| V2755 |
U-v lens, per lens |
26 |
26 |
$263.16 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$149.50 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
21 |
13 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
44 |
40 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
13 |
13 |
$0.00 |