| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
776 |
766 |
$11K |
| V2020 |
Frames, purchases |
344 |
331 |
$8K |
| 92002 |
|
126 |
125 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
126 |
115 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
49 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
72 |
70 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$265.19 |
| V2756 |
Eye glass case |
142 |
137 |
$143.86 |