| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
300 |
295 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
155 |
153 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
96 |
95 |
$6K |
| V2020 |
Frames, purchases |
342 |
337 |
$5K |
| 92015 |
Determination of refractive state |
815 |
807 |
$1K |
| V2755 |
U-v lens, per lens |
186 |
181 |
$560.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
76 |
73 |
$524.58 |