| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
863 |
838 |
$32K |
| V2020 |
Frames, purchases |
1,013 |
993 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
445 |
437 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
952 |
932 |
$20K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
658 |
643 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
283 |
276 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
585 |
567 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
174 |
170 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
27 |
27 |
$807.30 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$425.41 |
| 92341 |
|
12 |
12 |
$294.12 |