| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
330 |
321 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
752 |
731 |
$12K |
| V2020 |
Frames, purchases |
942 |
912 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
154 |
146 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
226 |
219 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
962 |
933 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
30 |
30 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$270.00 |