| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
506 |
496 |
$19K |
| 92015 |
Determination of refractive state |
198 |
196 |
$5K |
| V2020 |
Frames, purchases |
290 |
283 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
214 |
206 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
42 |
$940.50 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$670.36 |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
12 |
12 |
$120.00 |