| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
121 |
119 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
26 |
24 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
28 |
28 |
$598.67 |
| V2020 |
Frames, purchases |
47 |
47 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
33 |
33 |
$0.00 |