| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
717 |
697 |
$12K |
| 92015 |
Determination of refractive state |
505 |
476 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
92 |
90 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
42 |
38 |
$2K |
| V2020 |
Frames, purchases |
607 |
583 |
$400.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
591 |
565 |
$44.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
64 |
64 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$0.00 |