| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,124 |
989 |
$15K |
| V2020 |
Frames, purchases |
242 |
216 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
75 |
59 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
39 |
38 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
53 |
50 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
49 |
38 |
$2K |