| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
940 |
894 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
289 |
275 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
390 |
371 |
$18K |
| V2020 |
Frames, purchases |
567 |
518 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
453 |
417 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
594 |
548 |
$12K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
192 |
163 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
18 |
14 |
$496.00 |
| 92250 |
|
13 |
12 |
$425.10 |