| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
623 |
495 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
259 |
213 |
$10K |
| V2020 |
Frames, purchases |
402 |
304 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
142 |
64 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
102 |
90 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
26 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
40 |
38 |
$810.36 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
56 |
27 |
$734.20 |
| 92370 |
|
62 |
30 |
$679.50 |