| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,068 |
998 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
242 |
227 |
$9K |
| V2020 |
Frames, purchases |
156 |
151 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
42 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
24 |
24 |
$480.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$336.00 |