| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,579 |
3,168 |
$175K |
| V2020 |
Frames, purchases |
4,183 |
3,707 |
$162K |
| 92015 |
Determination of refractive state |
3,927 |
3,476 |
$53K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,164 |
1,058 |
$52K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,760 |
1,550 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
598 |
566 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,656 |
1,468 |
$27K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
648 |
520 |
$20K |
| 92002 |
|
140 |
129 |
$6K |
| 92341 |
|
98 |
91 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
291 |
281 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
14 |
$558.47 |
| V2756 |
Eye glass case |
177 |
170 |
$202.95 |