| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
458 |
386 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
311 |
268 |
$11K |
| V2020 |
Frames, purchases |
470 |
390 |
$10K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
464 |
387 |
$5K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
436 |
361 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
45 |
40 |
$3K |