| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
519 |
467 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
104 |
94 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
153 |
148 |
$5K |
| V2020 |
Frames, purchases |
141 |
137 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
154 |
148 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
12 |
$1K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
112 |
107 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |