| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,045 |
1,908 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,364 |
1,298 |
$39K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
709 |
663 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,021 |
981 |
$21K |
| V2020 |
Frames, purchases |
1,632 |
1,521 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
789 |
494 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
54 |
49 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
28 |
24 |
$1K |
| 92002 |
|
13 |
13 |
$718.89 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
20 |
14 |
$80.76 |