| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,161 |
1,150 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
263 |
261 |
$5K |
| 92015 |
Determination of refractive state |
367 |
364 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
136 |
136 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
628 |
624 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
91 |
90 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
109 |
106 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
221 |
220 |
$2K |