| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
863 |
829 |
$31K |
| 92250 |
|
787 |
747 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
469 |
443 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
501 |
479 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
167 |
162 |
$12K |
| V2020 |
Frames, purchases |
740 |
716 |
$7K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
150 |
73 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
252 |
195 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
101 |
101 |
$60.00 |