| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,636 |
1,621 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
467 |
465 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,334 |
1,325 |
$27K |
| 92015 |
Determination of refractive state |
1,409 |
1,400 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
138 |
138 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
616 |
615 |
$8K |
| 92341 |
|
12 |
12 |
$274.36 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
60 |
59 |
$0.00 |