| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92002 |
|
490 |
480 |
$22K |
| 92015 |
Determination of refractive state |
1,622 |
1,616 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
723 |
717 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
182 |
180 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
164 |
164 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
134 |
130 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
362 |
362 |
$5K |
| V2020 |
Frames, purchases |
378 |
378 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
291 |
290 |
$2K |