| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
662 |
572 |
$36K |
| 92015 |
Determination of refractive state |
787 |
690 |
$24K |
| V2020 |
Frames, purchases |
673 |
602 |
$17K |
| 92250 |
|
389 |
356 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
401 |
366 |
$11K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
317 |
310 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
62 |
62 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
15 |
$789.30 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
30 |
12 |
$263.25 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
61 |
29 |
$0.00 |