| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,105 |
1,060 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
420 |
412 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
467 |
450 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
254 |
248 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
101 |
88 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
37 |
30 |
$2K |
| V2020 |
Frames, purchases |
31 |
25 |
$334.80 |