| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
781 |
748 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
183 |
179 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
153 |
144 |
$4K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
419 |
413 |
$4K |
| 92133 |
|
13 |
13 |
$38.87 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
20 |
20 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
44 |
44 |
$0.00 |
| 99305 |
|
17 |
16 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
75 |
75 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
44 |
44 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
72 |
72 |
$0.00 |
| 92341 |
|
22 |
22 |
$0.00 |
| V2020 |
Frames, purchases |
93 |
93 |
$0.00 |