| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
677 |
663 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
337 |
331 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
359 |
338 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
258 |
250 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
113 |
112 |
$7K |
| V2020 |
Frames, purchases |
390 |
372 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
22 |
12 |
$437.50 |
| V2781 |
Progressive lens, per lens |
141 |
133 |
$0.00 |