| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
740 |
620 |
$10K |
| V2020 |
Frames, purchases |
136 |
131 |
$2K |
| 92225 |
|
76 |
63 |
$2K |
| 92310 |
|
16 |
14 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
24 |
24 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$750.88 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$239.47 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$130.00 |