| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
426 |
376 |
$11K |
| V2020 |
Frames, purchases |
349 |
319 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
164 |
140 |
$8K |
| 92370 |
|
422 |
385 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
239 |
215 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
62 |
51 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
43 |
42 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
12 |
$819.90 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$372.31 |
| V2756 |
Eye glass case |
16 |
16 |
$60.00 |