| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,059 |
960 |
$34K |
| V2020 |
Frames, purchases |
718 |
648 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
290 |
260 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
362 |
342 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
556 |
500 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
363 |
317 |
$10K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
145 |
130 |
$4K |