| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
186 |
180 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
134 |
130 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
113 |
109 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
72 |
70 |
$2K |
| 92015 |
Determination of refractive state |
503 |
489 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
176 |
170 |
$135.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
60 |
58 |
$40.00 |