| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,052 |
681 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
350 |
256 |
$23K |
| V2020 |
Frames, purchases |
841 |
537 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
90 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
352 |
248 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
412 |
264 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
603 |
354 |
$3K |