| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
980 |
936 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
364 |
360 |
$11K |
| V2020 |
Frames, purchases |
706 |
678 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
388 |
373 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
50 |
38 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
43 |
37 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
50 |
37 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
34 |
$1K |
| 92341 |
|
38 |
38 |
$723.04 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$456.02 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$244.92 |