| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
632 |
594 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
310 |
298 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
111 |
106 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
135 |
130 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
134 |
130 |
$3K |
| V2020 |
Frames, purchases |
95 |
82 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
17 |
$384.96 |