| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
6,487 |
5,359 |
$146K |
| 92002 |
|
2,408 |
2,162 |
$146K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,029 |
1,560 |
$143K |
| V2020 |
Frames, purchases |
3,354 |
2,502 |
$87K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,273 |
1,203 |
$87K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
636 |
479 |
$55K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,026 |
2,262 |
$49K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,713 |
1,139 |
$30K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,397 |
621 |
$19K |
| 92250 |
|
78 |
60 |
$2K |
| 92083 |
|
12 |
12 |
$615.12 |
| 76514 |
|
16 |
16 |
$109.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
117 |
75 |
$6.14 |