| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
459 |
445 |
$9K |
| 92250 |
|
247 |
245 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
163 |
162 |
$7K |
| V2020 |
Frames, purchases |
168 |
165 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
141 |
140 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
116 |
113 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$590.28 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
15 |
$375.00 |