| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
544 |
494 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
66 |
60 |
$6K |
| V2020 |
Frames, purchases |
215 |
186 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
107 |
87 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
59 |
49 |
$2K |
| 92002 |
|
18 |
17 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
68 |
29 |
$781.44 |