| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,744 |
1,674 |
$41K |
| V2020 |
Frames, purchases |
1,185 |
1,154 |
$37K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
325 |
316 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
215 |
206 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
539 |
528 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
909 |
890 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
54 |
46 |
$5K |
| 92002 |
|
58 |
57 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
42 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$641.16 |
| 92341 |
|
28 |
28 |
$385.28 |
| 2026F |
|
330 |
301 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$0.00 |