| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
754 |
697 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
285 |
265 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
196 |
189 |
$6K |
| V2020 |
Frames, purchases |
368 |
364 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
51 |
50 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
55 |
55 |
$803.34 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$358.25 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$288.00 |