| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
586 |
583 |
$21K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
347 |
345 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
713 |
700 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
26 |
$2K |
| V2020 |
Frames, purchases |
227 |
227 |
$80.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
229 |
229 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
41 |
$0.00 |
| 3072F |
|
15 |
15 |
$0.00 |