| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
794 |
716 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
167 |
167 |
$12K |
| 92015 |
Determination of refractive state |
973 |
933 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
234 |
226 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
591 |
525 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
227 |
210 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$937.06 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$297.17 |
| 92083 |
|
12 |
12 |
$50.22 |
| V2755 |
U-v lens, per lens |
712 |
479 |
$30.68 |