| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,971 |
1,971 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
991 |
991 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
275 |
275 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
132 |
132 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
169 |
169 |
$12K |
| V2020 |
Frames, purchases |
787 |
787 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
250 |
250 |
$7K |
| 92002 |
|
66 |
66 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
25 |
25 |
$697.09 |
| 92250 |
|
14 |
14 |
$397.52 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,093 |
1,093 |
$0.00 |