| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,486 |
1,084 |
$46K |
| 92015 |
Determination of refractive state |
1,104 |
1,012 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
277 |
267 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,403 |
1,039 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
118 |
116 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
511 |
386 |
$12K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
159 |
142 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
108 |
68 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
545 |
423 |
$0.00 |