| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
591 |
591 |
$12K |
| V2020 |
Frames, purchases |
568 |
568 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
409 |
409 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
119 |
119 |
$6K |
| 92015 |
Determination of refractive state |
512 |
512 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
70 |
70 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
561 |
561 |
$2K |