| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
292 |
292 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
85 |
84 |
$2K |
| V2020 |
Frames, purchases |
207 |
204 |
$587.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$523.32 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
176 |
171 |
$183.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
37 |
37 |
$0.00 |