| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
499 |
486 |
$20K |
| 92015 |
Determination of refractive state |
484 |
440 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
107 |
107 |
$7K |
| V2020 |
Frames, purchases |
346 |
313 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
91 |
87 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$525.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
84 |
84 |
$524.00 |
| 92002 |
|
13 |
13 |
$493.09 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$455.16 |
| 92341 |
|
18 |
15 |
$425.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$323.80 |