| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2799 |
Vision item or service, miscellaneous |
783 |
781 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,250 |
2,105 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
89 |
89 |
$9K |
| V2020 |
Frames, purchases |
457 |
446 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
115 |
115 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
43 |
43 |
$3K |
| 92341 |
|
106 |
104 |
$2K |
| 92015 |
Determination of refractive state |
236 |
236 |
$1K |
| 92342 |
|
26 |
26 |
$337.74 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
42 |
42 |
$73.20 |