| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
607 |
577 |
$19K |
| V2020 |
Frames, purchases |
709 |
660 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
340 |
313 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
140 |
136 |
$5K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
101 |
99 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
34 |
34 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$819.32 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
12 |
$728.80 |
| 92015 |
Determination of refractive state |
13 |
13 |
$349.70 |
| 92341 |
|
13 |
13 |
$250.76 |