| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
1,449 |
1,272 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
471 |
332 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
236 |
209 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
185 |
175 |
$9K |
| V2020 |
Frames, purchases |
356 |
250 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
80 |
60 |
$482.95 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
112 |
67 |
$187.18 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
27 |
15 |
$131.29 |