| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,756 |
1,634 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
572 |
533 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
189 |
188 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
47 |
46 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
58 |
58 |
$1K |
| V2020 |
Frames, purchases |
67 |
67 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
28 |
$325.00 |