| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
204 |
200 |
$10K |
| 92015 |
Determination of refractive state |
228 |
223 |
$8K |
| V2020 |
Frames, purchases |
183 |
180 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
188 |
185 |
$4K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
89 |
88 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
71 |
70 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$835.44 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$381.84 |