| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,474 |
1,472 |
$153K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
835 |
834 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
629 |
628 |
$80K |
| 92310 |
|
219 |
219 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
75 |
61 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
68 |
66 |
$3K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
65 |
63 |
$2K |
| V2020 |
Frames, purchases |
44 |
42 |
$460.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
36 |
$420.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
75 |
72 |
$250.00 |
| V2755 |
U-v lens, per lens |
72 |
70 |
$0.00 |