| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
768 |
766 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
746 |
738 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
247 |
247 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
52 |
52 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
446 |
439 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
295 |
292 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$0.00 |
| V2020 |
Frames, purchases |
925 |
910 |
$0.00 |