| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
364 |
359 |
$8K |
| 92015 |
Determination of refractive state |
322 |
317 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
90 |
89 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
43 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
85 |
83 |
$2K |
| V2020 |
Frames, purchases |
532 |
525 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
242 |
239 |
$408.45 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
160 |
159 |
$0.00 |