| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,049 |
856 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
777 |
637 |
$27K |
| V2020 |
Frames, purchases |
403 |
321 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
54 |
41 |
$3K |
| 92250 |
|
58 |
52 |
$2K |
| 92081 |
|
62 |
55 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
57 |
43 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
55 |
42 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
25 |
$810.95 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18 |
14 |
$0.00 |