| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,087 |
1,083 |
$22K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
391 |
391 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
625 |
616 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
154 |
153 |
$7K |
| V2020 |
Frames, purchases |
576 |
575 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
350 |
200 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
553 |
552 |
$495.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
87 |
52 |
$430.00 |