| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
413 |
401 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
269 |
265 |
$13K |
| 92250 |
|
269 |
251 |
$11K |
| V2020 |
Frames, purchases |
289 |
278 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
280 |
271 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
88 |
84 |
$6K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
171 |
165 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
145 |
138 |
$4K |
| 83861 |
|
286 |
135 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
60 |
59 |
$2K |
| 92025 |
|
70 |
67 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
30 |
$763.68 |
| 92083 |
|
12 |
12 |
$473.77 |