| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
2,114 |
1,900 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
942 |
913 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,825 |
1,069 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
401 |
392 |
$19K |
| V2020 |
Frames, purchases |
1,273 |
1,239 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
80 |
71 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21 |
12 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
57 |
28 |
$712.50 |