| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
500 |
476 |
$14K |
| V2020 |
Frames, purchases |
326 |
319 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
379 |
362 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
238 |
233 |
$10K |
| 92015 |
Determination of refractive state |
541 |
516 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
304 |
284 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
84 |
81 |
$758.74 |
| 92341 |
|
14 |
12 |
$409.08 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
58 |
$351.10 |