| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,008 |
868 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
443 |
379 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
401 |
338 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
138 |
118 |
$9K |
| V2020 |
Frames, purchases |
329 |
290 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
138 |
79 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
252 |
118 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
103 |
56 |
$922.53 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
12 |
$291.62 |