| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,555 |
1,518 |
$62K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
628 |
615 |
$44K |
| V2020 |
Frames, purchases |
1,255 |
1,227 |
$43K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
356 |
345 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,157 |
1,131 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
549 |
544 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
39 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$481.52 |